Trigeminal Neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is a rare type of facial pain syndrome. It affects only 4 in 100,000 people each year. It is characterized by severe, stabbing pain involving just a portion of one side of the face. It may involve the chin, the cheek, the forehead, or a combination of these. It is a brief, stabbing pain that occurs continuously for varying lengths of time. It may go away for weeks or months at a time but then returns.

Trigeminal neuralgia is not responsive to normal pain medications, including prescription narcotic medications. It is often associated with triggering activities that may include touching a particular point on the face or inside the mouth, or chewing. It is frequently mistaken as a dental problem. It is not uncommon for patients to have had unsuccessful dental work including root canals or extractions before being diagnosed with a neurological disorder.

Trigeminal neuralgia pain is so severe, some patients may contemplate harming themselves just to avoid the next searing jolt of pain. There are medications that can help. A response to Tegretol (carbamazepine) helps to confirm the diagnosis. This medication has been replaced with new medications such as Neurontin (Gabapentin) and Lyrica which have fewer side effects. These medications are membrane stabilizing medications which treat the abnormal nerves that are firing excessively. This mechanism of drug action can provide pain relief. If these medications don't work in true trigeminal neuralgia, it is often because the dose has not been sufficiently increased. This is something that must be done gradually to reduce side effects. The most common side effect is drowsiness.

Patient Testimonials and Support

Many patients benefit from talking to others who have suffered from and have undergone successful treatment for this dreadful disorder. Hearing them personally describe their experience being pain-free and returning to their lives is invaluable. While we strongly protect confidentiality, we encourage patients being able to support one another by describing their experience. If you tell us, we can arrange such a confidential discussion for you.

Publications

Scholarly articles published in peer-reviewed journals by Dr. Stechison pertaining to the surgery and intraoperative neurophysiological monitoring of the Trigeminal Nerve.

Stechison, MT, Brogan M: Transfacial Transpterygomaxillary Access of Foramen Rotundum, Sphenopalatine Ganglion, and the Maxillary Nerve in the Management of Atypical Facial Pain. Skull Base Surgery 4:15-20, 1994
Stechison, MT, Moller A, Lovely TJ: Intraoperative Mapping of the Trigeminal Nerve Root: Technique and Application in the Surgical Management of Facial Pain. Neurosurgery 38:76-92, 1996
Stechison MT, Kralick FJ: The Trigeminal Evoked Potential: Part I-Long Latency Responses in Awake or Anesthetized Subjects. Neurosurgery 33:633-638, 1993
Stechison MT: The Trigeminal Evoked Potential: Part II – Intraoperative Recording of Short Latency Responses. Neurosurgery 33:639-644, 1993
Neurophysiological Monitoring During Cranial Base Surgery. J of Neuro-Oncology 20:313-325, 1994