Trigeminal Neuralgia Treatment

Sometimes trigeminal neuralgia treatment fails to respond to medications despite increasing doses and/or changing medications.

In this case gamma knife surgery may be an excellent option. This is a type of radiation that is narrowly targeted to the nerve root to stop the pain.

Although called 'surgery" it is actually radiation and the machine used looks somewhat like a CT scanner.

Gamma knife for trigeminal neuralgia

Most studies about gamma knife radiosurgery have shown that 80-90% of patients have pain relief in 3-4 weeks after surgery. A very small percentage of patients have no relief from gamma knife surgery and may have to have open surgery. If this is needed, the complications of surgery apply which are 1-2% risk of infection and rarely stroke. Stroke risk is usually determined by other factors such as hypertension, high cholesterol and obesity.

Lack of response to medication may be especially true if the nerve is in contact with a small blood vessel. If this is the case, the constant irritation of the nerve can only be relieved by surgery.

Here, a different type of surgery is performed as a small piece of Teflon is inserted between the nerve and the offending vessel (usually a tiny artery). This surgery is an open procedure unlike the gamma knife.