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Trigeminal Neuralgia

WHAT YOU NEED TO KNOW:

Trigeminal neuralgia (TN) is a problem with your trigeminal nerve that causes severe facial pain. You have a trigeminal nerve on each side of your face. The nerves allow you to feel pain, touch, and temperature changes in different areas of your face.

Trigeminal Nerve

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Tests:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • CT scan: This is also called a CAT scan. An x-ray machine uses a computer to take pictures of your head. It may be used to look at bones, muscles, and blood vessels. You may be given dye through an IV to help your healthcare provider see the pictures better. Tell the healthcare provider if you are allergic to iodine or seafood. You may also be allergic to the dye.
  • MRI: Pictures are taken of your head so healthcare providers can examine your trigeminal nerve. You will need to lie still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury.
  • MRA: This test is used to look at the blood vessels in your brain. Healthcare providers will look for the location of the blood vessel that is pressing on your trigeminal nerve. An MRA may be done with an MRI to help your healthcare provider better plan your TN treatment.

Treatment:

Your TN may go away on its own without treatment. If your TN is caused by another condition, your healthcare provider will also treat that condition.

  • Medicines:
    • Anticonvulsants: These control seizures, help prevent pain attacks, and decrease symptoms.
    • Antidepressants: These decrease pain and help prevent depression.
    • Muscle relaxers: When your facial muscles are relaxed, you may be less likely to have pain attacks.
    • Pain medicines: You may be given pain medicines if your facial pain is severe.
  • Procedures: You may need a procedure or surgery to treat your TN if it does not get better with medicines. A procedure or surgery may also be needed if you cannot take the medicines used to treat TN.
    • Nerve block: This is an injection of medicine that makes you lose feeling in an area of your body. You may need a nerve block if your pain is not going away, or is getting worse. A nerve block may also be used to make you lose feeling in an area before a procedure is done.
    • Microvascular decompression: This is surgery to separate your trigeminal nerve from the blood vessel pressing on it.
    • Percutaneous procedures: These procedures help control your pain by destroying an area deep in your skull where nerve branches come together. Healthcare providers will insert a needle and tube through the base of your skull to reach this area.
    • Peripheral techniques: Peripheral techniques are done to block the nerve impulses that cause your pain attacks. Your healthcare provider may destroy the nerve with alcohol (medicine) injections, or he may freeze the nerve. He may also use surgery to remove part of the nerve.
    • Stereotactic radiosurgery: This is also called Gamma Knife surgery. Radiation beams are used to remove a blood vessel that is pressing on the nerve. You may have some pain relief right away after radiosurgery. It may take at least 1 month before you have decreased pain.

RISKS:

  • Medicines used to treat your TN can cause organ damage. Medicines may not help your TN. Over time, some medicines may stop working. Procedures and surgeries to treat TN can cause facial pain or damage. You may have changes in your vision, hearing, memory, speech, or sense of smell or taste. You may have trouble chewing or get mouth sores. You may get an infection, or have brain and nerve damage, seizures, a stroke, or even death. After treatment with a procedure or surgery, your TN may come back, or you may have new TN pain.
  • If your TN is not treated, your pain attacks may get worse and occur more often. If a growth or other medical problem is causing your TN pain, you may not get proper treatment. You may begin to have a dull, constant ache in areas of your face. Your TN pain, and fear of an attack, may be so bad that you stop brushing your teeth, eating, and drinking. This may lead to dental problems, poor nutrition, weight loss, and dehydration. You may feel tired, anxious, or depressed.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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