Trigeminal Neuralgia (Facial Spasms)

Trigeminal neuralgia also known as trigeminal facial spasms is a nerve disorder that causes sudden electric shock-like pains near the eyes, ears, nose or lips. The affected three-part (trigeminal) nerve which sends sensations to all parts of the face can impact one side of the face, but some trigeminal neuralgia patients may experience pain on both sides of the face at different times.

Trigeminal neuralgia is often called the “suicide disease” because of the excruciating pain it causes.

Symptoms

Intensely sharp or stabbing pain is felt in the face where the nerve branches are distributed—lips, eyes, nose, scalp, forehead, upper jaw and lower jaw. Numbing sensations and sometimes itching or skin sensitivity is experienced in trigeminal neuralgia patients.

A less common form of the disorder called “atypical trigeminal neuralgia” can sometimes cause a dull, burning pain with sudden episodes of electric shock-like sensations.

Diagnosis

The quality, characteristics and occurrence or frequency of the pains are used to diagnose trigeminal neuralgia. It is important to note the differences in pain for appropriate diagnosis.

Treatments

Drug treatments for trigeminal neuralgia patients may include anticonvulsants, antidepressants, topical creams, narcotics/opioids, among others.

IV medicines that have been used include lidocaine, ketamine and adenosine 5'-triphosphate (ATP).

Medical treatments options for trigeminal neuralgia include nerve blocks, Botox injections, pulsed radiofrequency and transcranial magnetic stimulation.

Surgical treatments range from microvascular decompression surgery to radiosurgery. It should be noted that certain surgical methods are not used for neuropathic pain and could increase the chance of complications. Your physician can guide you in choosing the appropriate form of surgical treatment for trigeminal neuralgia should it be necessary.

Stereotactic Radiosurgery (SRS)

Stereotactic radiosurgery (SRS) is a non-invasive specialty that does not involve any incisions. At Sentara Martha Jefferson, our specialized physicians use a linear accelerator to direct beams of precisely focused radiation at the trigeminal nerve.  The radiation beam damages the trigeminal nerve without destroying it completely. Over the course of a few weeks, pain relief gradually occurs. The results are usually long-lasting, and permanent.

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