Understanding Trigeminal Neuralgia

Understanding Trigeminal Neuralgia
What Is It? / Types / Treatment Options / More Info

200 Berteau Avenue, Elmhurst, IL 60126 / (331) 221-2050 / www.chicagock.com

What is Trigeminal Neuralgia?
Trigeminal neuralgia (TN), sometimes referred to as Tic Douloureux, is
a nerve disorder that can cause intense pain on either side of the
face. The pain can be triggered when cold air touches specific facial
areas or with movements like chewing, talking or swallowing. The
unpredictable, severe pain from TN can significantly impact one's
quality of life.
The disorder occurs in the trigeminal, or fifth cranial, nerve that
controls sensation in the face. TN is more common in women, and
patients are typically middle-aged or seniors.


Trigeminal Neuralgia:

Typical & Atypical Cases

TYPICAL TN
In typical TN, patients suffer from
unpredictable episodes of stabbing,
electric shock-like pain in a
consistent location. Such patients can
reproduce an attack by touching a
“trigger point” on the face or
performing a speciﬁc activity like
chewing or talking.

ATYPICAL TN
With atypical TN, the pain is a persistent
dull ache or burning sensation in one
part of the face. However, episodes of
sharp pain can complicate atypical TN.
There is usually not a speciﬁc trigger
point with atypical TN, while the pain
grows worse over time.


What are the treatment options?
All forms of TN can be treated with medication, surgery or radiosurgery, all of which
offer varying degrees of success. Medication can relieve pain in most TN patients,
though it’s not always effective and can produce fatigue or other signiﬁcant side
effects. Nevertheless, medication is generally the ﬁrst line of treatment.
Please note: We encourage consumers to thoroughly review and understand all treatment options. The information presented
here is not all-inclusive. Rather, it represents a starting point to learn more about medical conditions and treatment options.
There is no substitute for consulting a medical professional.

Surgery
Radiosurgery

Treatment Option One:

Surgery

If patients do not find relief from pain medication, they may be a candidate
for surgery, including a procedure known as microvascular decompression,
or MVD. In younger TN patients, MVD is often preferred, because it holds
the potential of a long-term cure without causing significant facial
numbness.
Other procedures known as radiofrequency rhizotomy, glycerol rhizotomy
or nerve balloon compression attempt to destroy trigeminal nerve fibers
that cause pain. These operations have varying degrees of success and pain
relief can return after a few years. Therefore, the treatment is typically
repeated several times over a patient’s life.
Open surgery also carries risks of infection, arterial or cranial-nerve injury
or stroke. Certain patients have medical conditions that prevent surgery,
while others may object to surgery.


Treatment Option Two:

Radiosurgery

Though primarily used to treat benign and malignant tumors throughout the body,
stereotactic radiosurgery can also treat additional medical conditions including
trigeminal neuralgia. The CyberKnife® is an advanced technology that performs
stereotactic radiosurgery. During the procedure, the machine delivers highly focused
radiation to the trigeminal nerve to interrupt pain-causing ﬁbers. While other
stereotactic radiosurgery treatment options can require a metal frame be attached
to the patient's skull under local anesthesia, CyberKnife does not. CyberKnife doesn’t
require a head frame. It uses a highly advanced computer-imaging system that can
compensate for small head movements, allowing the patient to lie comfortably
during the procedure.

TN treatment with the CyberKnife begins with a CT or MRI brain scan, particularly
of the trigeminal nerve area. With a CT scan, doctors often use a dye injected into
the spinal ﬂuid through a spinal tap to improve the imaging.


Treatment Option Two:

Radiosurgery

• During CyberKnife treatment, high-dose radiation beams are precisely aimed along a segment of the trigeminal nerve.
• The pinpoint accuracy of the CyberKnife procedure spares healthy tissue and does not require surgery or sedation.
• Stereotactic radiosurgery for TN is typically a one-time, outpatient procedure and is completed within an hour.
• TN does not have a cure, but pain can be reduced or eliminated in about 85 to 90 percent of patients who are treated with
stereotactic radiosurgery, according to clinical data.

• The most common side effect is facial numbness that likely correlates with the degree of pain relief.
• Pain relief with CyberKnife treatment can be substantially faster than other forms of radiosurgery.
• This may be the result of the system’s accuracy. Follow-up is needed before doctors can estimate how long pain relief will last.


Our Center
CyberKnife Center of Chicago opened in August 2009 as a service of Elmhurst Memorial Hospital. Our center is
part of the hospital’s radiation oncology department, which is accredited by the American College of Radiology.
Our state-of-the-art CyberKnife® technology can offer hope to patients in the Chicago suburbs and beyond.
CyberKnife Center of Chicago has a dedicated CyberKnife Nurse Navigator who works with our physicians and
patients to coordinate care and manage the treatment process. We know that any diagnosis is a scary one and
we’re here to make your experience as easy as possible. We encourage you to call us anytime with questions or
concerns.
Medical Director: Dr. Andy W. Su
CyberKnife Nurse: Griselle Romero, RN

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Understanding Trigeminal Neuralgia

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Understanding Trigeminal Neuralgia