Trigeminal Neuralgia

This condition affects the trigeminal nerve, which carries sensation from your face to your brain. Some patients may experience:

• Episodes of severe, shooting pain that may feel like an electric shock
• Spontaneous attacks of pain triggered by touching the face, chewing, speaking or brushing teeth
• Pain that occurs with facial spasms
• Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
• Pain affecting one side of the face at a time

In most cases, the cause is a loop of an artery lying in contact with the trigeminal nerve just as it approaches the brain stem. In some cases, the cause is a tumour (usually benign). In this case, surgery is often recommended.

There are no specific diagnostic tests for trigeminal neuralgia, and symptoms can be similar to other facial pain disorders. Therefore, it is vital to seek medical care if you experience unusual, sharp pain around the eyes, lips, nose, jaw, forehead and scalp, especially if you have not had recent dental or other facial surgery.

There are several effective ways to alleviate the pain, including various medications. Surgical treatment via a craniotomy may be considered if medications are ineffective. Surgery can relieve pressure on the trigeminal nerve from a nearby blood vessel and can be diagnosed with an MRI.

Postoperative care

• Keep the wound dry for five days. You can get wet in the shower, but pat the area dry rather than rub.
• Do not use shampoo for ten days postoperatively
• GP review for wound review and removal of staples on day seven.
• No driving for at least three months until review with Dr Shiva
• Monitor for any wound redness, discharge or fevers
• Monitor for new symptoms, including worsening headaches, upper or lower limb symptoms, speech or visual symptoms, seizures
• Six-week review with Dr Shiva