Microvascular Decompression Trigeminal Neuralgia

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microvascular-decompressionMicrovascular Decompression Surgery or (MVD) is a procedure that is often performed to provide relief of compression that can sometimes occur on the cranial nerve. The surgery is used to treat a wide range of conditions; however it has proven to be extremely successful in the treatment of trigeminal neuralgia.

There are many different causes for Trigeminal Neuralgia, however one of the most common occurs when a vein or artery compresses on the nerve root. This compression can cause the nerves to misfire and send wrong messages to the brain. Especially with Trigeminal Neuralgia, patients often suffer excruciating pain in the facial region.

What is Microvascular Decompression Surgery?

Microvascular Decompression surgery is a medical procedure that is often done to provide pain relief that is associated with the trigeminal neuralgia. Trigeminal Neuralgia is caused when the fifth cranial nerve is irritated. This will result in the individual experience severe pain, usually on one side of the face.

Generally when Microvascular Decompression is used to treat trigeminal neuralgia, the skull is opened where the trigeminal nerve is located. Doctors will place a small sponge between the nerver and either the petrosal vein or cerebellar artery. This sponge will remove any compression the vessels may cause on the nerve.

What You Need to Know About Microvascular Decompression Surgery

Generally when a patient is poised to have the surgery to treat trigeminal neuralgia, the patient usually undergoes a battery of tests. The patient will also have a consultation with the doctor, where they will go through everything related to the surgery.

On the day of the surgery, the patient will be given general anesthesia. One the patient is under the anesthesia; an incision is made behind the ear. Various parts of the skull are removed until the doctors are able to expose the brain. The doctors will they try and get to the trigeminal nerve where it is connected to the brain stem. The vessel that is causing the compression is identified and a sponge is placed between the nerve and the vessel. Once this is all done, the opening is closed up and everything sutured back together. The entire procedure should take anywhere from 2-3 hours.

It should be noted that Microvascular Decompression Surgery for trigeminal neuralgia requires the use of general anesthesia. Patients who are considered to be in poor health or who have different medical conditions may not be considered for this treatment.

After Microvascular Decompression Surgery?

Once the surgery is complete, the patient may experience certain side effects. Some of the most common symptoms that they may experience are headaches and nausea. Discomfort and pain will occur and as a result narcotic medication will be prescribed. These will prescribed for a very short period of time.

The patient will have certain restrictions as they recover from the surgery. Regular activities should not be done or restricted. No heavy lifting should occur and patients should not sit for long periods of time. This will continue for a few weeks after surgery is complete.

Is Microvascular Decompression for Trigeminal Neuralgia Effective?

The success rate in using Microvascular Decompression for Trigeminal Neuralgia is extremely high. The success rate is around 95%. 20% of the patients who have this surgery done will experience reoccurrence of pain within 10 years.  One of the good things as it relates to the surgery is the fact there is little or no numbness of the face.

Is Microvascular Decompression Surgery Risky?

All surgery is risky, whether major or minor. Typically with Microvascular Decompression Surgery for trigeminal neuralgia, there is the possibility of complications such as infection, bleeding, blood clots and reactions to anesthesia occurring. Other problems could possibly occur such as swelling of the brain, stroke, seizures and nerve damage. Nerve damage is the most common and depending on the affected nerve, there may be numbness of the face, loss of hearing, facial paralysis, facial numbness, problems swallowing and double vision.

Below is a video that will look at Microvascular Decompression Surgery.

Trigeminal Neuralgia and What You Need To Know

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trigeminal-neuralgia-painTrigeminal Neuralgia (tic douloureux) is a painful neurological condition that many people often claim is a curse, due to the pain associated with it. It is a rare condition and it is mostly found in people over 50 years of age, even though people in other age groups can be affected by it. Women have a higher chance of getting the condition and this is 1.5 more times likely, compared to men. The Trigeminal Neuralgia Association has stated that 5% of patients who suffer from this condition also have a family history of it.

The pain associated with Trigeminal Neuralgia can be debilitating as the pain is so severe. The symptoms associated with the disorder are severe facial pain, which affects one side of the face. The pain is a result of an artery or blood vessel pressing down on the trigeminal nerve located at the base of the brain. Generally the pain from the condition, usually affects the lower parts of the face such as the jaw. The pain is often described as a sharp, acute pain that is almost similar to electric shocks.

Aside from the blood vessels pressing down on the Trigeminal Neuralgia, damage to the nerve can also because by injuries to the face, surgical or dental procedures. However in many of the patients who suffer from this condition, there is no outright cause.

The trigeminal nerve is possible for the different sensations that are felt in the face. This nerve has been acknowledged as one of the 12 pairs of cranial nerves. As it relates specifically to the Trigeminal Neuralgia, it splits; one goes to the left side of the head, while the other goes to the right side of the head. From the left and the right nerve, it then divides up into three separate branches. All of the branches control different feelings and sensations in the face. The first branch is responsible for the different feelings into forehead, eye and nose. The second branch is responsible for the lips, sides of the nose, cheeks, gums and upper teeth. The third branch controls the sensations associated with the lip, gum and jaw.

The onset of pain associated with Trigeminal Neuralgia can often be triggered by simple actions such as eating, brushing the teeth, applying makeup, shaving, sneezing, drinking cold or hot beverages and even a light wind. Most people who suffer from the condition often state that the pain just appeared out of nowhere one day.

There are two types of pain that are associated with this condition. These pains have been identified as either “classical” or “atypical”. Generally with classic pain, the patient will have periods where they feel no pain, however when the pain comes it will be intense and severe and often feel like electrical shocks. Atypical pain is also severe and intense and the patient experienced the stabbing pain, as well as it having a burning or pulsating feel to it. Atypical sufferers do not have their pain periods where their pain goes away.

Be Wary of Facial Pain, It Could Be Trigeminal Neuralgia

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facial-pain1People who often experience bouts of pain in the nose, lips, jaws, eyes, or forehead should be very wary. All these symptoms could be signs of the very serious medical condition known as Trigeminal Neuralgia (TN).

Trigeminal Neuralgia is a very common condition, were the patient suffers from excruciating pain. This condition has been often called the “suicide disease”, as many people cannot handle the intense pain and would rather end their life and instead of dealing with it.

This condition usually occurs when an arm of vein or artery makes contact with a nerve at the bottom of the brain. The contact caused by the vein or artery will cause pressure to be placed on the nerve and this in turn results in a breakdown or something going wrong in the brain.

The episodes of pain associated with the condition can be extremely severe. It can be triggered by different activities such as brushing the teeth, chewing and even wind blowing on the face. Generally only one side of the face is affected by pain at a given time. The pain can be focused in one area or spread into a much wider area.

There are many different treatments for this particular condition. These include the use of different types of medications, drugs and injections. If any of pulse fail to work, then surgery is often considered.

Botox in Treating Trigeminal Neuralgia

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botox-trigeminal-neuralgiaThere is evidence that is suggesting that getting a shot of Botox may help to ease the pain associated with trigeminal neuralgia.

Trigeminal neuralgia or “tic doulourex.” Is a condition that the person will feel acute, intense and stabbing facial pain.

Botox contains a tiny dose of the botulinum-A toxin, that has been tested with people who have migraines or temporomandibular joint syndrome (TMJ) pain. It however is mainly used in cosmetic surgery circles to treat wrinkles.

Botox Study on Trigeminal Neuralgia

 

A study using 13 people was conducted to see the effects of Botox on Trigeminal Neuralgia.  The people in the study are reported severe facial pain that was attributed to their trigeminal neuralgia. They were all then given one treatment of Botox to the affected facial regions.

According to the report, facial pain eased in all 13 patients over the next 60 days.

Ten days after Botox treatment, some of the patients reported drastic drop in facial pain. Twenty days after treatment, many of the patients were symptom free.

Overall the intensity of the pain was reduced and all of the patients relied very little on the medication they were taking for their facial pain.

Four patients stopped using those medications all together. The study showed that the other patients cut their use of medications for facial pain by more than half.

The research also showed that there weren’t any bad interactions with Botox and other medication.

The effects of Botox on trigeminal neuralgia only lasted 2 months, after that time the study was completed. The researchers are not sure how long the benefits would have lasted and more research needs to be done on the topic.

Trigeminal Neuralgia and Pregnancy

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trigeminal-neuralgia-pregnancyFor people who suffer from trigeminal neuralgia and are considering or are pregnant, then the doctor will suggest they come of the drugs.

Early in the stages of the pregnancy the doctors will recommend stopping the use of pain medications to help with trigeminal neuralgia. The doctor will determine when or what situation the pain medications are needed.

The reason behind this move is that the drugs can affect the unborn child. There are some medications that are considered to be “safe” to be taken while pregnant,  but this is why it is important to correspond with the doctor.

The side effects of the drugs may include birth defects and other problems that could arise throughout the pregnancy.

For some people who are pregnant and have trigeminal neuralgia, the pain might be bearable, for others it could be a nightmare, especially if the medication is not available to treat the condition.

In being off the pain medication, some people have to find other methods to cope with the pain problems. The biggest advice to keep the pain away is to not chew, crunch or do anything that could cause the pain to start.

Video Overview For Trigeminal Neuralgia Part 2

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This video will look at the benefits of surgery to treat trigeminal neuralgia. It will look at the benefits that can be gained from doing the surgery and also the pain relief that is possible from having the procedure done.

Trigeminal Neuralgia and Acupuncture

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acupuncture-trigeminal-neuralgiaTrigeminal neuralgia is a condition that affects the trigeminal nerve. The condition is also known as “tic douloreaux” due to the fact that facial muscle spasms often accompany the pain. This debilitating condition is one that often produces intense, periodic facial pain along one or more of the three branches of the trigeminal nerve. The pain the person who suffers from this condition is very painful and it can last anywhere from seconds to minutes. The pain from trigeminal neuralgia can often be activated by simple activities such as brushing of teeth, eating putting on makeup or washing the face. Stress, heat, wind, or cold may also intensify the condition. It is often common in women who are over 40. Trigeminal neuralgia may become debilitating due to the chronic pain and it can last for years.

The treatment for trigeminal neuralgia is often surgery or drug therapy treatment. To control the pain doctors may administer drugs; however these usually have significant side effects and risks. Surgical intervention is usually the last option available to provide relief.

Acupuncture and Trigmenial Neuralgia

If you suffer from neuralgia or facial pain, then acupuncture treatment should be considered.  The trigeminal nerve serves three areas of the face and it roughly corresponds to the forehead and eyebrow, the eye and cheek and upper jaw, and the lower jaw. Trigeminal neuralgia can be associated with structural problems inside the skull and doctors will often treat it with drugs or surgery. Acupuncture is an option for some people as there are few side effects compared to surgery and drugs.

Developed in China over 2500 years ago, acupuncture has been used for the treatment of painful medical conditions that affect the head and these would include trigeminal neuralgia. The theory of acupuncture is based on energy flowing through the body on specific pathways called meridians. When the pathways become blocked, pain often develops. Acupuncture often require others very fine needles been inserted into these points on the pathway to enable the smooth flow of energy. This will also result in pain relief. There are many acupuncture points in the face that will directly link to the three branches of the trigeminal nerve. In using acupuncture to treat trigeminal neuralgia, very fine needles are placed into the corresponding facial points as a way to unblock the energy. There are times that the needles will be stimulated with electricity as a way to strengthen the overall treatment.

Over time the pain associated with the condition will become more complex and difficult to treat. As a result of this acupuncture should be done as soon as the symptoms appear. Acupuncture is shown to be more effective when applied immediately after the appearance of the syndrome.

The Success of Trigeminal Neuralgia and Acupuncture

There is no research or studies done to show if acupuncture is able to successfully treat trigeminal neuralgia. Many people have claimed success in using acupuncture to treat their pain and some have said that they are pain free or the pain is not as harsh as it used to be before. On the other hand, there have been people who suffer from trigeminal neuralgia and have acupuncture done and experienced no change in their condition. The results may vary and acupuncture should not be seen as a definitive method for treatment of this painful condition. Alternative medicine does work, however it is good to get an opinion from a doctor.

Gamma Knife Surgery for Trigeminal Neuralgia

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What is Gamma Knife Surgery?

Gamma Knife surgery is one of the more popular treatments for people who suffer from brain tumors. Over the years it has proved itself as an effective treatment for people who suffer from trigeminal neuralgia. It is a non-invasive procedure that can be applied to patients where brain surgery is not an option.

Gamma Knife is the same as neurosurgery, except that it is non-invasive. As a result of this, there is no need for surgical incisions to be made to expose the brain. This reduces one of the risks that can occur from surgical complications. The Gamma Knife is not a knife but it is complex machine that uses cobalt-60 as the energy and is able to focus a precise intersection of 201 beams of these gamma rays to perform radiosurgery. During the treatment the 201 beams of gamma radiation are focused at eliminating the lesion. Once this has been applied, the lesion should reduce in size and eventually disappear. The brain tissue is not over exposed to the gamma beams and only the treated tissue is affected.

Gamma Knife patients are able to enjoy the benefits from this non-invasive form of brain surgery. They have very few risks and a long hospital stay is not required.

The Use of Gamma Knife and Trigeminal Neuralgia

The Gamma Knife has been used for years in the treatment Trigeminal Neuralgia. This type of radiosurgery has become the treatment of choice for people who do not respond to the typical medical therapy. The advancement in imaging as well as the experienced gained from its use has aided in the success of this practice.

The first use of the gamma knife on Trigeminal Neuralgia was in 1951, when the inventor, Lars Leksell used this radiosurgery technique to target the trigeminal ganglion. He used a conventional stereotactic frame and produced an orthovoltage x-ray tube that was used to target the region. The results from this period over the next 40 years were less than stellar; this was due to poor fixation of the target as well as poor imaging. 1996 brought about a study from the University of Pittsburgh, where they decided to revist the use of radiosurgical treatment of trigeminal neuralgia. Aided by the use of High resolution MRI, they were able to target more accurately. They also targeted the the proximal trigeminal nerve near the pons rather than the ganglion, as was done in previous attempts. The study resulted in 94% of patients who participated in the study having a significant reduction in the pain they felt. There were some patients, who experienced complications, but this was mainly limited to facial numbness and this often occurred at a frequency of less than 10%. Gamma Knife surgery for trigeminal neuralgia has become a safe alternative to the more traditional forms of surgery and also one of the major treatments.

How is Gamma Knife Surgery Performed?

For the surgery to be done properly you need to have a multidisciplinary group of assembled. Generally this will include radiation oncologist, neuroradiologist, neurosurgeon and medical physicist. These are needed to achieve an effective and safe treatment.

The use of Gamma Knife surgery to treat Trigeminal Neuralgia is often done in four steps.

In the first step of the treatment a Leksell stereotactic head-frame is placed on the patient. This is done as there needs to be high quality and accurate imaging. To get great results, magnetic resonance imaging often used in the process. From here the trigeminal nerve is identified and the gamma knife and all can be used to eradicate the target. The trigeminal nerve is often targeted at the location of an imaged vascular compression, or at the site of exit of the trigeminal nerve from the pons if no compressing vessel is identified. The success of the treatment at this exit zone is often due to the fact that the proximal nerve is covered by oligodendrocyte myelin, which is usually more radiosensitive than the distal swan-cell myelin. That could be one explanation or it could also be due to the fact that the concomitant irradiation of the dorsal root entry zone in the brainstem.

Great care is taken in this procedure to ensure that the brainstem is not affected by radiation. Because the Gamma knife is very accurate this can be easily accomplished. This process is the often done under local anesthesia.

During the procedure, great care is taken to ensure that the brainstem is protected from radiation exposure. This can be accomplished easily from the precision of the Gamma Knife. The entire procedure is performed under local anesthesia and mild sedation.

Results of Gamma Knife on Trigmenial Neuralgia

Patients who usually have Gamma Knife surgery done on Trigmenial Neuralgia often report an immediate decrease in pain. Attacks still occur, but the pain associated with it is milder than what they were used to. As the weeks progress, many patients reported that they experienced no new attacks. This is probably secondary to delayed demyelination injury to the nerve. There are also some views that the gamma knife irradiation has a differing effect on the myelinated and unmyelinated fibers. This in turn leads for the pain to be controlled, without dysesthesia.

The results from different studies have shown great success in treating the condition.  Ninety percent of patients with trigeminal neuralgia experienced a significant reduction in the pain they felt after around four weeks. The study went on to show that one-third of the patients experienced some amount of numbness in the face, but 80% showed a significant improvement in their quality of life since the numbness was much more tolerable than the facial pain.

In over 30 years, more than 100,000 people have received gamma knife treatment. The use of the gamma knife has clear advantages to open surgery in many cases, and its use will continue to grow.

Gamma Knife Effective At Treating Trigeminal Neuralgia

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trigeminal-neuralgia3Research has shown that Gamma Knife Stereotactic Radiosurgery (GKRS) is an effective treatment for the medical condition trigeminal neuralgia. This is a common condition that is characterized by excruciating facial pain.

Gamma Knife has proven itself to be as safe and effective treatment for people who suffer from trigeminal neuralgia.  It is very popular as patients won’t have to worry about the potential facial paralysis and the long-term recovery experienced with conventional surgery.

Research studies conducted have only way to the outcome of patients who have had gamma knife radio surgery for their trigeminal neuralgia. A group of 400 patients who suffered from the condition were given 201 narrow “pencil beams” of radioactive cobalt-60 at the trigeminal nerve focusing precisely on the target and minimizing radiation effects to surrounding healthy tissues.

In the study 90% of the patients with trigeminal neuralgia had significant pain relief after around one month. Approximately one-third of these patients did experience some degree of facial numbness, but 80 percent reported a significant improvement in their quality of life since the numbness was much more tolerable than the facial pain.

Trigeminal neuralgia, also known as tic douloureaux, is a condition that is characterized by electric shock-like pain in one or more of the three trigeminal nerve distributions in the face. Common triggers of pain associated shall include brushing the teeth, eating, talking, wind and exposure to cold air.