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Disorders
We Treat
Trigeminal Neuralgia
Trigeminal neuralgia (TN) is a disorder of the fifth
cranial (trigeminal) nerve that causes episodes of intense, stabbing,
electric shock-like pain in the areas of the face where the branches of
the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw,
and lower jaw. A less common form of the disorder called "Atypical
Trigeminal Neuralgia" may cause less intense, constant, dull burning
or aching pain, sometimes with occasional electric shock-like stabs. Both
forms of the disorder most often affect one side of the face, but some
patients experience pain at different times on both sides. Onset of symptoms
occurs most often after age 50, but cases are known in children and even
infants.
Gamma knife radiosurgery has in recent
years become the treatment of choice for people unresponsive to medical
therapy for TN. Recent advances in imaging and increased experience with
its use, have underscored the importance of gamma knife as a treatment
option and good pain relief has been achieved with its use.
The exact mechanism of pain relief is unknown.
It is thought to be a two step process. Patients report an immediate decrease
in the intensity of the pain even if the attacks still occur. This is
thought to be the result of an immediate interruption of ephaptic transmission.
Several weeks later there is complete cessation of the attacks. This is
probably secondary to delayed demyelination injury to the nerve.
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