Trigeminal Neuralgia
Question: What is the current therapy approach for (facial) trigeminal neuralgia?

Answer: Trigeminal Neuralgia refers to the pain secondary to irritation or stimulation of the facial nerve which goes to the lower half of the face. This is also called Tic Douloureux. This syndrome is usually seen after age 30. It is extreme pain, usually to the lips and cheek. There tend to be recurring waves of pain usually lasting less than 1-2 minutes. This can be triggered by seemingly simple things like a breeze on the cheek. Indeed, light touch often sets this off, whereas heavy stimulation does not. There are several ways to treat this pain. Initially, drugs are used. Tegretol(carbazepine) is usually given first. If this is not successful dilantin(phenytoin) is used. If drugs are not Successful, radiofrequency ablation (also called percutaneous retrogasserian rhizotomy) is used. Occasionally, injection of glycerol or something similar is used in place of the radiofrequency ablation. This surgical approach will give numbness to the face in the affected area. This pain can occasionally reoccur after surgery in 20 % of patients.

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