Also known as tic douloureux, trigeminal neuralgia is a chronic condition affecting the trigeminal nerve. The nerve provides sensations in the face including the forehead, eyes, mouth, sinus cavities, and jaw.
The condition occurs when a blood vessel compresses on the nerve. It causes pain during face-related activities such as teeth brushing, face washing, eating and drinking, shaving, and putting on makeup. The pain tends to come on suddenly on one side of the face. Areas where the pain often appears are the teeth, cheek, jaw, lips, and gums. Pain around the eye or forehead appears less common.
Trigeminal neuralgia microsurgery can be very satisfying for both the patient and the neurosurgeon. I am always humbled and grateful when I see patients who get relief from trigeminal neuralgia, one of the most terrifying and severe forms of facial pain. The pictures below for the final steps in a surgery that I performed for a patient with this debilitating disease. She had lasting relief from her symptoms.
Image 1: The trigeminal nerve (pointer) exiting the brainstem being compressed on 2 sides by arteries.
Image 2: Dissecting away the 2 arteries causing pressure on the nerve.
Image 3: The material in place (pointer) that now protects the nerve from arterial pressure.
