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What can I Expect During Trigeminal Neuralgia Surgery?

By Meshell Powell
Updated May 17, 2024
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Trigeminal neuralgia is a painful disorder that affects the trigeminal nerve, the largest of the facial nerves. Patients with trigeminal neuralgia often explain the pain as a sudden burst of electric-shock pain that is more excruciating than any other pain that has been experienced. Doctors are frequently unable to find an exact cause for this disorder, although people with certain other medical conditions, such as multiple sclerosis, may be at higher risk for developing trigeminal neuralgia. When medications and lifestyle changes have not been successful, trigeminal neuralgia surgery may become necessary. There are several types of trigeminal neuralgia surgery available, including the use of injections, electrical current, or radiation.

Facial injections are a mild form of trigeminal neuralgia surgery. Alcohol injections are fairly common solutions for temporary pain relief. In this procedure, alcohol is injected just underneath the skin around the different branches of the trigeminal nerve in order to temporarily numb the nerve. Alcohol injections may provide pain relief that lasts for several weeks or several months before needing to be repeated. Glycerol injections are sometimes used instead of alcohol, and the results as well as the side effects are similar to those of the alcohol injections.

Percutaneous stereotactic radiofrequency thermal rhizotomy, or PSR, is a type of trigeminal neuralgia surgery that involves the use of electrical currents to provide pain relief. This type of procedure works by destroying the nerve fibers that are associated with pain. The doctor inserts a needle into the face and through an opening in the skull that leads to the trigeminal nerve. Electricity is then used to damage the nerve so that pain is no longer experienced by the patient. This procedure has a high success rate, although it may need to be repeated from time to time and may cause some degree of facial numbness.

Another type of trigeminal neuralgia surgery, known as stereotactic radiosurgery, uses radiation to eliminate the pain caused by trigeminal neuralgia. In this procedure, radiation is delivered directly to the root of the trigeminal nerve to block pain. Unlike other types of trigeminal neuralgia surgery, stereotactic radiosurgery does not generally require any kind of anesthesia, as it is considered to be a painless procedure. This type of surgery may have mixed results, with more than half of the patients reporting positive results. Unfortunately, it often takes between several weeks and several months following the procedure for pain relief to begin.

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