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Trigeminal Neuralgia Type 1

What is Trigeminal Neuralgia Type 1?

Trigeminal Neuralgia – also called tic douloureux – is a facial pain condition that affects the largest nerve in the head, the fifth cranial (trigeminal) nerve. The trigeminal nerve carries sensations from the face to the brain.

TN is often caused by loss of or damage to the nerve’s protective coating, myelin. The damage of the myelin results from irritation of the nerve, most often triggered by compression of the trigeminal nerve by a normal blood vessel next to the brainstem.

The pain attacks worsen over time. As the condition progresses, there are fewer and shorter pain-free periods before they recur. This facial pain condition affects the quality of one’s life, making everyday activities harder for the individual.

Symptoms of  Trigeminal Neuralgia Type 1

Trigeminal Neuralgia patients have experienced some or all of the following symptoms:

  • Pain episodes affect one side of the face.
  • Sporadic burning or shock-like facial pain.
  • Pain felt near the lips, eyes, nose, scalp, forehead, upper and lower jaw.
  • Pain triggered by touch, sounds or everyday activities.
  • Pain episodes last from a few seconds to a couple minutes.
  • Tingling, numb sensation or constant aching pain before a new episode begins.

Treatment Options for Trigeminal Neuralgia Type 1


In almost every instance of trigeminal neuralgia type 1 (TGN1), medication is tried to avoid surgery. There are two medications that are considered the best and most effective — Tegretol and Trileptal. Both drugs are anticonvulsants. Narcotic pain relievers are not typically used, as they have only minimal effects (if any) on trigeminal neuralgia and can be highly addictive.

Some people do not find relief with medication, experience side effects, or simply notice it becoming less effective as time goes by. If you have been taking medication and are experiencing any of these problems, you still have several options.

Medication is rarely a long-term solution for the relief of trigeminal neuralgia pain. Luckily, several treatment options are available to help bring lasting results.

Microvascular Decompression

When drug therapy isn’t working, microvascular decompression (MVD) is often considered as your next option. This innovative surgery usually results in permanent relief of trigeminal neuralgia symptoms. Several factors dictate if you’re a candidate for MVD, including whether your symptoms stem from nerve compression caused by a blood vessel, whether you can withstand anesthesia, and others.

A high-resolution MRI known as a FIESTA MRI will reveal whether your trigeminal neuralgia is caused by nerve compression. During a microvascular decompression procedure, a tiny Teflon pad is placed between the nerve and vein or artery to create a cushion. Many times, relief is instantaneous and recovery is relatively short in comparison to other intracranial surgeries.

What Makes a Candidate for MVD?

  • Your trigeminal neuralgia has not responded to medication .
  • Your facial pain reoccurs after a percutaneous or radiosurgery procedure.
  • Your facial pain is in the ophthalmic (1 of the trigeminal nerves) nerve or all three trigeminal nerves.

Gamma Knife Radiosurgery

Sometimes, MVD isn’t a viable option for a number of reasons. In these cases, the next consideration is Gamma Knife Radiosurgery (GKRS). Although it is not technically a surgery, it does provide a very effective means of treatment for those who are not candidates for microvascular decompression.

Gamma Knife Radiosurgery is a completely noninvasive procedure that uses tiny, highly focused beams of radiation to pinpoint and deliver a therapeutic dose of radiation to a very specific area. As with other radiation treatments, it’s used to destroy the offending tissue, but unlike its earlier cousins, does not cause damage to surrounding tissues. It’s well-tolerated by the vast majority of patients and has a quick recovery time with very few side effects.

What Makes a Candidate for Gamma Knife Radiosurgery?

  • Your age or other health conditions place you at high risk for conventional surgery.
  • You do not want to undergo a traditional surgical procedure.
  • Other treatment options have failed.

Percutaneous Rhizotomy

Another option to eliminate pain associated with trigeminal neuralgia is percutaneous rhizotomy. During this minimally invasive procedure, heat is applied through a small electrode to the portion of your trigeminal nerve that is causing pain. This option is usually considered when you are not a candidate for microvascular decompression or Gamma Knife Radiosurgery.

Stimulator Placement

If none of the above treatment options succeed in relieving your pain, you can consider stimulator placement. This procedure involves placing a small electrode under the skin near the location that is producing your pain. Small electrical pulses will be delivered to the nerve in attempts to stimulate the facial nerves and eliminate pain.

The first time that the electrode is positioned will be a trial run to ensure that the this is the correct treatment plan for you. Once it is determined that stimulator placement will reduce your pain, a permanent connection to the electrode will be implanted.

Why Choose Neurosurgeons of New Jersey?

When you are dealing with one of the most painful and debilitating conditions, you want to make sure you’re seeking the optimal treatments available. Neurosurgeons of New Jersey has doctors who focus on trigeminal neuralgia treatment and have specialized experience in determining the best course of treatment for your individual needs.

You will not find general surgeons at Neurosurgeons of New Jersey. Each surgeon is carefully vetted based on experience and track record for success in specific niches. This helps guarantee you will be receiving the best treatments possible.

In addition to having a top-notch team of neurosurgeons, Neurosurgeons of NJ also offers treatment at five facilities throughout New York and New Jersey, making seeking treatment close to home easier than ever.

Above all else, Neurosurgeons of New Jersey puts its patients at the forefront of everything they do. A strong commitment to patient-focused care carries through from the first visit to the last check-up. You are never a number on a list. We take the time to get to know you and your specific needs so you can receive the best care and treatment available.