Trigeminal neuralgia is characterized by recurrent short episodes of one-sided zapping, shooting, or excruciating spasms of facial pain. The pain may be so severe that the patient may cry out or visibly wince. The affected area of the face may become super-sensitive, with such minor stimulation as a light breeze, cold temperature, water from a shower, washing the face, shaving, or even eating can set off attacks of pain.
Medical Treatment of Trigeminal Neuralgia
The anticonvulsant carbamazepine is usually first line treatment.
Second line medications include baclofen, lamotrigine, oxcarbazepine, phenytoin, gabapentin, pregabalin, and antidepressants such as amitriptyline.
However these medications are not always effective and can cause side effects such as confusion and unsteady gait.
Surgical Treatment of Trigeminal Neuralgia
Surgical treatment, known as microvascular decompression, involves sub occipital craniotomy, mobilizing the offending blood vessel off the nerve, and insertion of a sponge to separate these structures.