Trigeminal neuralgia is frighteningly severe facial pain. An electric-shock-like facial pain that may last anywhere from a few seconds to a few minutes at a time and which may occur without warning. It is also known as ‘tic doulouroux’. The pain is usually on one side.
MRI scan: this is similar to a CT scan but uses magnetism rather than x-rays. The MRI scan will often demonstrate a vascular loop often compressing the origin of the trigeminal nerve. It can be slightly uncomfortable and noisy, and can make some patients feel claustrophobic: it takes around 30 minutes. You cannot have an MRI if you have a pacemaker or any kind of metal implant in your body. The London Clinic can offer MRIs on-site.
Surgery: Peter Bullock and The London Clinic can offer microvascular decompression to patients who are in pain in spite of maximum medical therapy – an operation to lift the vascular loop from the affected nerve. This prevents the nerve from ‘short circuiting’ and is the most effective long term control of the pain in adults that are fit for a general anaesthesthetic. Although trigeminal neuralgia affects mainly older patients, Peter Bullock has particular experience with some of the youngest patients ever treated in the UK, including teenagers.
Patients who are not fit enough to undergo microvascular vascular decompression may be offered GammaKnife®, CyberKnife® or local injections to the branches of the trigeminal nerve.