Trigeminal Neuralgia 

Western Massachusetts’ Leader in Treating Facial Pain

If you’re living with intense, debilitating facial pain from trigeminal neuralgia, we understand what you’re going through — and we’re here to help . Trigeminal neuralgia is a chronic (long-lasting) condition that causes sudden, unpredictable attacks of facial pain. It’s considered among the most painful conditions known to medicine.

At Baystate Health, you have access to highly experienced neurologists and neurosurgeons specializing in facial pain disorders. Our team includes a neurosurgeon who trained with the pioneer of the only cure for trigeminal neuralgia. Every year, we perform as many trigeminal neuralgia surgeries as some of the nation’s top academic centers — with excellent outcomes.

People come to us from around the world for our expertise in trigeminal neuralgia. We work with you to create a customized, effective treatment plan designed to bring relief and improve your quality of life.

Symptoms of Trigeminal Neuralgia

The main symptom of trigeminal neuralgia is extreme facial pain that can impact quality of life. Most of the time, the pain is on one side of the face, but in rare cases, it can show up on both. People often describe the pain as:

• An electric shock or lightning bolt
• Sharp and shooting
• Taser-like jolts inside the cheek

The pain comes and goes. Everyday activities like talking, brushing your teeth, or washing your face might trigger an attack. You can also have flares with no known trigger.

You may experience periods with few or no attacks (remission). Over time, these periods often become shorter, and some people may develop a constant aching or throbbing facial pain.

Usually, this pain occurs because of pressure (compression) on the trigeminal nerve. This nerve runs through your skull, sending sensations from your mouth, teeth, and face to your brain. In some cases, trigeminal neuralgia is caused by nerve damage from another condition such as multiple sclerosis (MS) or a tumor.

Diagnosing Trigeminal Neuralgia

Seeing a doctor experienced in trigeminal neuralgia diagnosis can make a big difference. At Baystate Health, our expert specialists work carefully to ensure an accurate diagnosis, helping patients avoid unnecessary treatments such as tooth extractions.

Diagnosing trigeminal neuralgia starts with an in-depth discussion about your symptoms and medical history. Your doctor may ask you:

• Do specific actions trigger pain?
• How severe is the pain?
• Is pain constant, or does it come and go?
• When did symptoms start?

You also get an imaging test called a magnetic resonance imaging (MRI) scan. An MRI uses magnets and radio waves to create detailed images of internal organs and soft tissues. These images help identify what’s causing trigeminal neuralgia by detecting or ruling out tumors and MS.

Trigeminal Neuralgia Treatment

Treatment for trigeminal neuralgia usually starts with medication. Neurologists (brain and spine physicians) commonly prescribe carbamazepine (Tegretol), a seizure medication, to treat trigeminal neuralgia.

The goal is to find the dose that offers the greatest relief with the fewest side effects. A high dose of carbamazepine may cause side effects such as confusion, drowsiness, or memory loss. When side effects become difficult to manage, a person may be a candidate for neurosurgery.

Trigeminal Neuralgia Surgery

There are several surgical treatments for trigeminal neuralgia:

• Jannetta procedure: This surgery, pioneered by Peter Jannetta, MD, is the only treatment that cures trigeminal neuralgia. Also known as microvascular decompression, the procedure relieves pressure on the trigeminal nerve. Learn more about the Jannetta procedure .
• Rhizotomy: A rhizotomy may be appropriate for patients who have trigeminal neuralgia due to multiple sclerosis or who aren’t good candidates for the Jannetta procedure. During a rhizotomy, your neurosurgeon injects a chemical near the trigeminal nerve that blocks pain signals.
• Gamma Knife radiosurgery: People with MS-related trigeminal neuralgia may be candidates for Gamma Knife treatment if a rhizotomy doesn’t successfully relieve pain. Gamma Knife radiosurgery uses radiation to target the trigeminal nerve and block pain signals. If you need Gamma Knife radiosurgery, we refer you to a center that offers the treatment.