Understanding Trigeminal Neuralgia

What Is It? / Types / Treatment Options / More Info

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

What is Trigeminal Neuralgia?

Trigeminal neuralgia (TN), sometimes referred to as Tic Douloureux, is a nerve disorder that can cause intense pain on either side of the face. The pain can be triggered when cold air touches specific facial areas or with movements like chewing, talking or swallowing. The unpredictable, severe pain from TN can significantly impact one's quality of life.

The disorder occurs in the trigeminal, or fifth cranial, nerve that controls sensation in the face. TN is more common in women, and patients are typically middle-aged or seniors.

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

Trigeminal Neuralgia: Typical & Atypical Cases

TYPICAL TNIn typical TN, patients suffer from unpredictable episodes of stabbing, electric shock-like pain in a consistent location. Such patients can reproduce an attack by touching a “trigger point” on the face or performing a specific activity like chewing or talking.

ATYPICAL TNWith atypical TN, the pain is a persistent

dull ache or burning sensation in one part of the face. However, episodes of sharp pain can complicate atypical TN.

There is usually not a specific trigger point with atypical TN, while the pain

grows worse over time.

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

What are the treatment options?All forms of TN can be treated with medication, surgery or radiosurgery, all of which offer varying degrees of success. Medication can relieve pain in most TN patients, though it’s not always effective and can produce fatigue or other significant side effects. Nevertheless, medication is generally the first line of treatment.

Please note: We encourage consumers to thoroughly review and understand all treatment options. The information presented here is not all-inclusive. Rather, it represents a starting point to learn more about medical conditions and treatment options. There is no substitute for consulting a medical professional.

Surgery

Radiosurgery

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

Treatment Option One:Surgery

If patients do not find relief from pain medication, they may be a candidate for surgery, including a procedure known as microvascular decompression, or MVD. In younger TN patients, MVD is often preferred, because it holds the potential of a long-term cure without causing significant facial numbness.

Other procedures known as radiofrequency rhizotomy, glycerol rhizotomy or nerve balloon compression attempt to destroy trigeminal nerve fibers that cause pain. These operations have varying degrees of success and pain relief can return after a few years. Therefore, the treatment is typically repeated several times over a patient’s life.

Open surgery also carries risks of infection, arterial or cranial-nerve injury or stroke. Certain patients have medical conditions that prevent surgery, while others may object to surgery.

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

Treatment Option Two:Radiosurgery

Though primarily used to treat benign and malignant tumors throughout the body, stereotactic radiosurgery can also treat additional medical conditions including trigeminal neuralgia. The CyberKnife® is an advanced technology that performs stereotactic radiosurgery. During the procedure, the machine delivers highly focused radiation to the trigeminal nerve to interrupt pain-causing fibers. While other stereotactic radiosurgery treatment options can require a metal frame be attached to the patient's skull under local anesthesia, CyberKnife does not. CyberKnife doesn’t require a head frame. It uses a highly advanced computer-imaging system that can compensate for small head movements, allowing the patient to lie comfortably during the procedure.

TN treatment with the CyberKnife begins with a CT or MRI brain scan, particularly of the trigeminal nerve area. With a CT scan, doctors often use a dye injected into the spinal fluid through a spinal tap to improve the imaging.

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

Treatment Option Two:Radiosurgery

•During CyberKnife treatment, high-dose radiation beams are precisely aimed along a segment of the trigeminal nerve.

•The pinpoint accuracy of the CyberKnife procedure spares healthy tissue and does not require surgery or sedation.

•Stereotactic radiosurgery for TN is typically a one-time, outpatient procedure and is completed within an hour.

•TN does not have a cure, but pain can be reduced or eliminated in about 85 to 90 percent of patients who are treated with stereotactic radiosurgery, according to clinical data.

•The most common side effect is facial numbness that likely correlates with the degree of pain relief.

•Pain relief with CyberKnife treatment can be substantially faster than other forms of radiosurgery.

•This may be the result of the system’s accuracy. Follow-up is needed before doctors can estimate how long pain relief will last.

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com

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St. Louis CyberKnife, a service of the renowned SSM Cancer Care, combines experienced physicians and the latest medical advances to provide patients with exceptional care.

Our doctors are board certified in radiation oncology and have several areas of specialty. Our CyberKnife nurse navigator is an integral part of our patient care approach, providing clinical support and coordination of care for our patients and their families. Our center utilizes the CyberKnife 9.0 system, which features a device that controls the width of the machine’s radiation beam, allowing clinicians to vary the beam size and treat a larger variety of tumors throughout the body. The capabilities of the more advanced technology allow for greater accuracy, quicker treatment times for patients and better avoidance of healthy tissue during treatment.

We are proud of the extensive experience and specialized expertise our physicians and caring staff bring to our patients. Please call us to learn more about treatment with the revolutionary CyberKnife.

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CyberKnife Nurse: Vicki Hartnett, RN, OCN

1011 Bowles Avenue, Ste. G-50, Fenton, MO 63026 / (636) 496-4660 / stlouiscyberknife.com