In the brain, there are 12 pairs of cranial nerves. These include the trigeminal nerves, which allow an individual to feel facial sensations.
Trigeminal neuralgia is a kind of facial pain caused by an issue with one of the three nerve branches: ophthalmic, mandibular, or maxillary. It is a chronic pain condition affecting the trigeminal nerve, which transmits sensations from the face to the brain.
Even simple face stimulation, such as brushing the teeth or applying makeups, can produce excruciating pain if you have trigeminal neuralgia.
Initially, you may experience brief and moderate episodes. However, trigeminal neuralgia might worsen over time, resulting in prolonged and more frequent shooting pain episodes. Trigeminal neuralgia affects more women than men. It is more common in people over the age of 50. Any physical touch with the face might trigger an episode. It is one of the most distressing conditions, leading to depression. The exact cause is unknown.
To get the best outcomes, the patient must first identify the trigger and then get treatment from an experienced neurosurgeon in Guntur, Andhra Pradesh.
At Dr. Rao’s Hospital, a renowned neurology hospital in Guntur, Dr. Mohana Rao offers medicinal and surgical treatment of trigeminal neuralgia.
He is a highly qualified, internationally trained, and experienced neurosurgeon in Guntur. Moreover, he provides advanced and minimally-invasive neurosurgical treatments for a wide range of neurological conditions.
In this article, we will discuss more trigeminal neuralgia and its treatment.
First, let’s know,
What Exactly is Trigeminal Neuralgia?
It is a type of facial pain resulting from trigeminal nerve inflammation. Excruciating pain occurs in single bouts or every few hours, minutes, or seconds. Between episodes, it can take months or even years.
Uncontrolled pain in some patients can progress to chronic pain syndrome, interfering with routine activities and may cause depression.
As mentioned above, it is more common in people over 50, but it can strike anyone at any age. On the right side of the face, it occurs five times more frequently than on the left.
Now, let’s know,
What Causes Trigeminal Neuralgia?
- Idiopathic trigeminal neuralgia is the most prevalent type of trigeminal neuralgia, implying the cause is unknown.
- The nerve may get pinched because of nearby blood vessels, aneurysms, or tumors.
- Inflammatory causes of trigeminal neuralgia can be induced by systemic diseases such as multiple sclerosis.
What are the Symptoms of Trigeminal Neuralgia?
- Occasionally, severe stinging or pricking pain like electrical shocks.
- Pain attacks might strike suddenly or be triggered by touching the face, chewing, speaking, or brushing.
- Pain outbursts can last anywhere from a few seconds to several minutes.
- Multiple episodes lasting days, weeks, months, or even years. Some people have periods of pain-free living.
- Before trigeminal neuralgia advances to spasm-like pain, there may be a persistent throbbing, burning feeling.
- The trigeminal nerve causes pain in the teeth, cheeks, jaw, gums, lips, less commonly, the eye, and forehead.
- The pain typically affects only one side of the face at a time; however, it can affect both.
- Pain can be localized or spread out across a broader area.
- Attacks become more frequent and intense as time passes.
Diagnosis of Trigeminal Neuralgia
- There are various reasons for facial pain. Often, migraine, cluster headache, post-herpetic neuralgia, and temporomandibular joint disease are misinterpreted as trigeminal neuralgia.
- A neurologist or neurosurgeon diagnoses the pain based on the nature, location, and sources of facial discomfort to confirm trigeminal neuralgia.
- Reflex tests and a neuro examination with an MRI scan are required to determine whether trigeminal neuralgia is caused by neurovascular conflict, multiple sclerosis, or a tumor.
Treatments for Trigeminal Neuralgia
Non-surgical treatment:
- Usually, doctors prescribe Carbamazepine for this condition. The treatment approach uses the smallest single dose possible to control pain. The doctor adjusts the frequency until the pain is alleviated completely.
- The regimen is kept for 6 to 8 weeks without modifying the dose once prolonged remission has been achieved.
- After then, the medicine can be gradually lowered and eventually stopped. In the event of a recurrence, this can be restarted. With time, recurrences become less responsive, necessitating several drugs.
Surgical treatment:
Microvascular decompression (MVD) and radiofrequency thermocoagulation (RFTC) are the most common surgical approaches for treating trigeminal neuralgia.
Radiofrequency Thermocoagulation
Radiofrequency rhizotomy is based on the temperature-dependent selective elimination of the pain-transmitting C fibers while maintaining the A-delta fibers. This treatment involves percutaneous retrogasserian needle implantation. 
Radiofrequency ablation is a safe, effective, and minimally invasive treatment for drug-resistant trigeminal neuralgia. The outcomes are comparable to those of microvascular decompression.
Rf ablation has become the procedure of choice in recent years, especially for older patients and those at high risk of anesthetic problems. Using radiofrequency electrical stimulation, this treatment destroys explicitly pain-related nerve fibers.
The surgeon administers anesthesia before inserting a hollow needle into the trigeminal nerve. Then, the anesthesia wears off gradually.
The neurosurgeon applies a modest signal after placing an electrode through the needle to confirm the pain spot. Once the surgeon identifies the target nerve fiber, they anesthetize the patient for radiofrequency thermal lesioning.
The neurosurgeon selectively heats the electrode and destroys the nerve fiber until it forms a lesion. For a short time after surgery, the patient may have facial numbness.
Microvascular decompression
It involves isolating blood vessels compressing the trigeminal nerve. The surgeon relocates or removes the affected trigeminal nerve from its blood vessel contact during the procedure. 
The neurosurgeon makes an incision behind the ear on the side of the pain site. Next, the surgeon makes a small incision in the skull and shifts the arteries down the trigeminal nerve. A cushioned space exists between the nerve and the arteries.
Microvascular decompression is successful in the majority of cases. However, in rare cases, the pain may return. Patients do not have facial numbness, unlike radiofrequency ablation. However, there is a rare risk of hearing loss, stroke, facial paralysis, or other problems.
Stereotactic radiosurgery
The neurosurgeon uses a highly concentrated radiation beam to destroy the affected trigeminal nerve fiber in this procedure.
- It is a non-invasive radiation treatment that has a higher success rate. Pain relief is seen after a few weeks following radiosurgery.
- If the pain recurs, the surgeon may repeat the procedure.
The final decision on whether or not to seek treatment rests with the patient. However, the sufferer should not be uninformed about the effective treatments available for this condition. Please be aware of your illness.
Dr. Mohana Rao, a seasoned neurosurgeon in Andhra Pradesh, always appeals to the general population to help patients diagnose and treat this ailment.