Headache and Facial Pain Center
Gamma knife stereotactic radiosurgery for trigeminal neuralgia:
What is trigeminal neuralgia?
Trigeminal neuralgia is a type of nerve pain that affects your face. You may feel an intense burst of pain in part of your face, usually one side of the jaw or cheek. The pain may be burning or sharp and so severe that you can’t eat or drink. A flare-up begins with tingling or numbness in the area. Then pain starts to come and go, often in bursts that last anywhere from a few seconds to two minutes. During a flare of the condition, these bursts of pain may become more and more frequent until the pain almost never stops. Although the intensity of the pain can make it hard to get through your day, it’s not life-threatening. This chronic pain condition can flare up for a few weeks or months. Then the pain disappears for a while, sometimes years.
How is trigeminal neuralgia treated?
The first line of treatment for patients with trigeminal neuralgia is always medication. Even minimally invasive surgery carries risks and should be considered a last resort. The drugs most commonly used for treating trigeminal neuralgia are medications that were originally developed for the treatment of epilepsy, such as carbamazepine, but are also quite effective in treating trigeminal neuralgia pain, and provide at least partial pain relief for up to 80% to 90% of patients. Unfortunately, these medications frequently cause side including dizziness, drowsiness, forgetfulness, unsteadiness, and nausea. Furthermore, these medications do not always remain effective over time, requiring higher and higher doses or a greater number of medications taken concurrently.
What about surgery?
Trigeminal neuralgia surgery is reserved for people who still experience debilitating pain despite best medical management. Surgical management can include microvascular decompression (sometimes referred to as the Janetta procedure), radiofrequency rhizotomy and stereotactic radiosurgery (Gamma Knife®).
How does Gamma Knife work?
The Gamma Knife is a device that delivers precise, controlled beams of radiation to targets inside the skull, including the brain and associated nerves. When treating trigeminal neuralgia, these radiation beams are aimed at the trigeminal nerve to stop the transmission of pain signals in to the brain. The procedure requires little or no anesthesia, and is performed on an outpatient basis. This procedure provides significant pain control or reduction in approximately 80% of patients within 4 to 6 weeks post-treatment. Side effects may include mild tingling or numbness in the face in 20% of patients.
What can expect at the Monmouth Neuroscience Headache and Facial Pain Center?
You will be evaluated by a physician panel consisting of a neurologist, radiation oncologist and neurosurgeon. Your evaluation with include: confirming the diagnosis of trigeminal neuralgia, reviewing your brain magnetic resonance imaging (MRI) scan to exclude other treatable causes of face pain, evaluating the severity of the pain and the medical treatments you have already tried, your general medical condition and your preference for treatment goals. If you are a candidate for the GammaKnife procedure, you can expect leave the appointment with all the appropriate information and a date for the procedure.
How can I find out more?
Ask your treating physician if you might be a candidate for referral to the center, or call out neuroscience coordinator at 732-923-6576.
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