Trigeminal neuralgia causes extreme facial pain that can be disabling. It is the most common form of facial pain in those over the age of 50. In nine out of 10 cases the symptoms of the problem began after the age of 40.

Interestingly, women are affected more often than men at a ratio of 1.5 to 1. It is unclear what causes trigeminal neuralgia. Is thought that the nerve may be pinched near the origin of the brainstem.

The painful symptoms that go along with trigeminal neuralgia entail shooting pains on one side of the face. The pain is described as being sharp, shooting and almost like an electrical shock. Everyday normal activities can bring on the pain such as shaving, washing or eating.

Physical examination is not usually extremely helpful in most patients with trigeminal neuralgia. All the cranial nerves should be tested to make sure their function is intact, facial expressions are normal, the tongue works fine and things like that.

When trigeminal neuralgia is present, the patient should have an MRI scan to rule out tumors or multiple sclerosis. Also, the MRI can sometimes show compression of nerves by blood vessels. Having said that, there’s not enough evidence to support whether or not blood vessels actually cause symptomatic nerve compression.

The International Headache Society has come up with multiple criteria to make the diagnosis of trigeminal neuralgia. The first is that the individual should have pain that lasts anywhere from a few seconds to a few minutes and occurs along the branches of the trigeminal nerve. The second is that the pain should be intense, sharp or static in nature. Another is that there should be no signs of other neurologic disorders.

When it comes to treatment for trigeminal neuralgia, the medication of choice is carbamazepine. Studies have shown this medication can reduce the symptoms in about 70% of patients. Additional medications that may have efficacy include Neurontin, baclofen, pregabalin and Lyrica.

When it comes to interventional treatments, there are a few options that pain management doctors in Arizona can choose from. Percutaneous balloon microcompression involves percutaneous introduction using a needle into what is called Meckel’s cavity. There is some data to back up this technique, with the advantage being that it treats the first branch of the trigeminal nerve selectively.

Another injection that can be performed involves glycerol being introduced into the area around the trigeminal nerve. This can be performed, or the Phoenix pain doctor can do a radiofrequency treatment on the area and attempt to obtain longer pain relief. There are no large-scale studies showing the long-term outcomes of this procedure. For really difficult cases, a surgical microvascular decompression and be performed which separates blood vessels from the nerves.

One of  the problems seen with medication management for trigeminal meralgia is the side effects associated with chronic medication use. What comes to treatment recommendations looking at all the options available, multi-modality treatment is most likely best. This includes medication management along with potentially glycerol injections and then maybe radiofrequency ablation.

The risks of these treatments are very low. In older patients radiofrequency ablation is recommended, and that younger patients microvascular decompression is to provide the longest term relief.

Arizona Pain Specialists has Award Winning pain doctors in Scottsdale, Phoenix, Chandler & Glendale who have extensive experience in effective facial pain treatment including TMJ and trigeminal neuralgia. Call (602) 507-6550 today for more information and scheduling.