Why does trigeminal neuralgia go away

What helps with trigeminal neuralgia?

Status: 25.11.2019 12:30 p.m. | archive
The causes of facial pain are only partially known.

Often all it takes is a breath of fresh wind, a chewing motion or a cold drink and the unbearable pain flashes across the cheek, ear, forehead or jaw. Many initially suspect an otitis media or tooth and jaw problems behind the stabbing attacks. In some cases, however, damage to the trigeminal nerve is the cause. It emerges from the skull in front of the ear and is responsible for sensory perception and muscle movements in the facial area.

When the trigeminal nerve is damaged

In classic trigeminal neuralgia, the pain occurs on one side in the facial area and lasts from a few seconds to two minutes - and in some cases even several times a day. In those affected, the cerebellar artery presses the cerebellar artery on the directly adjacent trigeminal nerve and damages it over time. As a result, there is a kind of short circuit in the nerve, which then transmits various stimuli in an uncontrolled manner to the pain nerve fibers.

The result is a short-term but extremely strong pain with the slightest touch or movement. Those affected feel as if a knife has been stabbed in the face.

Treat trigeminal neuralgia conservatively

Depending on its severity, trigeminal neuralgia can be treated in different ways: As conservative methods, acupuncture and a pain-preventive, drug therapy with anti-epileptic drugs come first. Often the symptoms can be stopped or at least noticeably alleviated.

OP for trigeminal neuralgia

However, in some patients the pain returns over time, so surgery can be considered. The neurosurgeon places a Teflon cushion between the nerve and blood vessel to relieve the pressure on the trigeminal nerve ("Jannetta operation").

The neurosurgeons reach the brain through a small opening in the skull behind the ear. Under the surgical microscope, they expose the trigeminal nerve and carefully detach it from the pulsating vein. So that the Teflon cushion keeps the artery away from the nerve, the doctor forms a loop out of it and uses it to fix the vein to a layer of connective tissue. So it no longer touches the nerve and the pain no longer occurs.

The procedure is not entirely risk-free, because a thrombosis in the veins could lead to swelling in the cerebellum. And if the trigeminal nerve is irritated or damaged, this can lead to a sensory disorder in the face.

Thermocoagulation: Use heat to fight pain

If open surgery on the brain is not possible, the affected nerve cells can be made insensitive for a longer period of time under local anesthesia using heat (thermocoagulation). Injecting alcohol into the nerve has a similar effect.

Experts on the subject

Dr. Christian Ziegeler
Head and facial pain clinic
Institute for Systems Neuroscience
Center for Experimental Medicine
University Medical Center Hamburg-Eppendorf
Martinistrasse 52
20246 Hamburg
www.uke.de

Prof. Dr. Henry W. S. Schroeder, director
Clinic and Polyclinic for Neurosurgery
University Medicine Greifswald
Sauerbruchstrasse
17475 Greifswald
www.medizin.uni-egoswald.de

additional Information
German Society for Neurosurgery (DGNC) e. V.
www.dgnc.de

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Visit | 11/26/2019 | 8:15 pm