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Trigeminal Neuralgia Type 2

What is Trigeminal Neuralgia Type 2?

The atypical form of the disorder known as Trigeminal Neuralgia Type 2 (TN-2), is characterized by a constant aching, burning and stabbing pain of somewhat lower intensity when compared to Type 1.

TN-2 is categorized to be more than 50% constant pain as opposed to sharp and fleeting pain. Both forms of pain may occur in the same person, sometimes at the same time.

TN-2 cases are presumed to be caused by a compression, except the compressions are occurring to the nerve’s motor branch and affect delayed-pain-carrying nerve fibers instead of “fast” pain fibers, or have created long-term, chronic injury anywhere along the nerve’s course.

Symptoms of  Trigeminal Neuralgia Type 2

Trigeminal Neuralgia Type 2 patients have experienced some or all of the following symptoms:

  • Constant aching, burning, stabbing pain.
  • Pain felt near the lips, eyes, nose, scalp, forehead, upper and lower jaw.
  • Pain triggered by touch, sounds or everyday activities.
  • Used to have primarily stabbing, fleeting pain but now have more burning, constant pain.

Treatments for Trigeminal Neuralgia Type 2

Finding the right treatment for trigeminal neuralgia type 2 is not always as straightforward as it could be, making it imperative that you are aware of all of the options available. From medication to surgical intervention, there are treatments that are right for just about everyone that suffers from trigeminal neuralgia type 2.


Medication is usually the first course of treatment that will be tried if you’re suffering from trigeminal neuralgia type 2. As a non-invasive approach, your surgeon or neurologist will likely want to see if you respond well to Tegretol or Trileptal. These anticonvulsants are both the gold standard when it comes to medication for trigeminal neuralgia, both type 1 and type 2.

Unfortunately, medication tends to be a short-term solution, as many people find it either doesn’t work well enough, or it becomes less and less effective as time goes by. There is also the possibility for developing unwanted side effects, making it impossible for patients to continue using them.

Microvascular Decompression

The next option that is typically explored after medication is microvascular decompression surgery (MVD). This innovative surgery addresses the true root of the problem – impingement of the trigeminal nerve from a vein or artery. MVD is a surgery that involves temporarily removing a small portion of bone at the base of the skull. The surgeon then isolates the nerve and offending blood vessel and carefully places a tiny Teflon sponge between the two. This effectively creates a buffer from the constant throbbing of the blood vessel against the nerve and eliminates the irritation. Those that undergo MVD for the trigeminal neuralgia usually notice positive results right away. The recovery time is relatively short for this procedure and the nerve’s function is not compromised.

Gamma Knife Radiosurgery

If it’s determined you’re not a good candidate for MVD, you still have a few options for addressing your trigeminal neuralgia type 2. The next consideration would likely be Gamma Knife Radiosurgery (GKRS). This completely non-invasive technique uses tiny beams of radiation that are finely focused and concentrated on the nerve (in this case) to damage or destroy part of the nerve tissue, preventing the misfired signals from causing the pain and associated sensations. This procedure is particularly helpful in cases of atypical trigeminal neuralgia where there is no nerve compression, or you are unable to undergo anesthesia.

Percutaneous Rhizotomy

Sometimes none of the former three treatments are viable options, putting percutaneous rhizotomy next on the list. This technique is minimally invasive and involves the surgeon isolating the nerve with an electrode and delivering a dose of electrical energy that will cause nerve damage, working in much the same way as GKRS, but via a different mode of energy delivery.

Pain Stimulator Placement

The last option is pain stimulator placement. The surgeon threads tiny electrodes underneath the skin to the site of the trigeminal nerve. Small impulses are used to disrupt the misfiring signals via these electrodes, preventing the nerve from sending false messages to the brain.

Why Choose Neurosurgeons of New Jersey

Your health and well-being are the most important points for everyone at Neurosurgeons of New Jersey – from the front office staff to your neurosurgeon. Each staff member takes a hands-on approach, keeping in mind that you’re a person – not a number.

In addition, only the finest specialized neurosurgeons and support staff make up the Neurosurgeons of New Jersey team. Our team is comprised of surgeons who specialize in very particular areas of study – we aim to break away from the mantra of “doing it all.” You can rest assured that your doctor only specializes in select areas, one of which will be your condition.

Neurosurgeons of New Jersey also has five convenient locations, making it possible for you to stay closer to home throughout the treatment process. The prospect of seeking atypical trigeminal neuralgia treatment is daunting enough without having to leave the state to receive top-notch care.