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Understanding Trigeminal Neuralgia
1. Understanding Trigeminal Neuralgia
What Is It? / Types / Treatment Options / More Info
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
2. 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.
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
3. 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.
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
4. 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
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
5. 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.
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
6. 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 Novalis Tx 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, Novalis Tx does not. Novalis Tx 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 Novalis Tx 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.
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
7. Treatment Option Two:
Radiosurgery
• During Novalis Tx treatment, high-dose radiation beams are precisely aimed along a segment of the trigeminal nerve.
• The pinpoint accuracy of the Novalis Tx 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 Novalis Tx 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.
555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com
8. Our Center
Under the leadership of Medical Director Dr. Brian Volpp, San Diego Radiosurgery offers advanced
cancer treatment by some of the region’s most experienced oncologists and technicians.
Our center uses a state-of-the-art radiosurgery platform called Novalis Tx, which offers patients fast,
accurate nonsurgical treatments for cancer and certain medical conditions without incision or sedation.
We were one of the first facilities in the country to have respiratory gating technology, allowing greater
protection of normal tissue during treatment.
Medical Director: Dr. Brian Volpp, M.P.H
Nurse: Cathy Blazek, RN, BSN
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555 East Valley Parkway, Escondido, CA 92025 / (760) 739-3835 / www.sdradiosurgery.com