Trigeminal Neuraligia

Your doctor will typically prescribe medication to reduce or block the pain signals that are sent to your brain in order to treat trigeminal neuralgia.

• Antiseizure medication. Trigeminal neuralgia is typically treated with carbamazepine (Tegretol, Carbatrol, and other brands), which has been demonstrated to be successful in treating this condition. Trigeminal neuralgia may also be treated with valproate, oxcarbazepine (Trileptal, Oxtellar XR), lamotrigine (Lamictal), phenytoin (Dilantin, Phenytek, Cerebyx), and other anticonvulsant medications. Other medications may also be utilized, such as gabapentin (Neurontin, Gralise, Horizant), pregabalin (Lyrica), topiramate (Qsymia, Topamax, and others), and clonazepam (Klonopin).

• Your doctor might change the kind of anticonvulsant you’re taking or up the dosage if the one you’re taking starts to become less effective. Anticonvulsant side effects can include nausea, sleepiness, dizziness, and confusion. Furthermore, genetic testing could be advised before to starting carbamazepine because it can cause a dangerous medication reaction in certain individuals, primarily those of Asian descent.

• Baclofen (Gablofen, Lioresal, Ozobax) and other muscle relaxants can be administered with or without carbamazepine. Drowsiness, nausea, and disorientation are possible side effects.
• Botox injections. Injections of onabotulinumtoxinA (Botox) may lessen trigeminal neuralgia pain in those whose drugs are no longer effective, according to small trials. Before this treatment is utilized extensively for this ailment, more research must be conducted.

• Decompression of microvascular structures. To prevent the nerve from malfunctioning, this technique entails shifting or eliminating blood vessels that come into touch with the trigeminal nerve. In microvascular decompression, the side of your pain is incised behind the ear by your doctor. Your surgeon will next create a soft cushion between the trigeminal nerve and the arteries by making a tiny incision in your head and moving any arteries that are in contact with the nerve.
  
  Your surgeon might remove a vein if it is squeezing the nerve. If arteries aren’t pushing on the trigeminal nerve, doctors may also do a nerveectomy during this treatment.
  
  Microvascular decompression is a good long-term pain management technique; nonetheless, 3 out of 10 patients will experience a 10-year pain recurrence. A stroke or other issues, as well as diminished hearing, facial paralysis, and face numbness, are possible side effects of microvascular decompression. After this operation, the majority of patients experience no facial numbness.

• Gamma knife stereotactic radiosurgery of the brain. During this process, a surgeon targets the trigeminal nerve root with a targeted radiation dose. In order to cause damage to the trigeminal nerve and lessen or eliminate pain, this technique uses radiation. Pain subsides gradually over a period of up to one month.
  
  For most patients, brain stereotactic radiosurgery is helpful in relieving pain. Like any surgery, there is a chance of recurrence, usually within three to five years. Should the pain return, either repeat the operation or try a different one. A common adverse effect that might happen months or years after the treatment is facial numbness.