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Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a nerve disorder that causes a pain frequently described as a lightning strike or electric shock to the face.

This pain comes from the trigeminal nerve, which carries sensations of touch and pain from the face, eyes, sinuses and mouth to the brain.

The primary symptom of trigeminal neuralgia, also called tic douloureux, is excruciating pain. This may be a sudden, intense flash of pain (type 1 or TN1) or a chronic, burning sensation (type 2 or TN2).

Trigeminal neuralgia: what you should know

  • When trigeminal neuralgia occurs in adults younger than 50, it can be caused by multiple sclerosis.
  • TN pain can be triggered by any touch or vibration, including eating, talking or brushing teeth. Even anxiety can trigger an attack. 
  • Trigeminal neuralgia is not life-threatening, but it can be both physically and mentally debilitating. Over time, people who suffer from TN have fewer and shorter periods without pain.

Care for trigeminal neuralgia at Rush

Treatment options for trigeminal neuralgia can depend on the following:

  • What type it is (either TN1 or TN2)
  • Whether all three branches of the trigeminal nerve are affected
  • What the cause of the pain is (for example, whether from multiple sclerosis or blood vessels being compressed, known as vascular compression)

Medical options: Doctors at Rush work with patients to explore medical options for nerve pain relief, including nerve blocks for temporary relief. These are injections of pain-relieving drugs directly into the affected nerve.

Surgical options: For trigeminal nerve pain unrelieved by medication, surgery may be an option. Neurosurgeons at Rush have extensive experience treating trigeminal neuralgia, including the following procedures:

  • Microvascular decompression: Your neurosurgeon moves the blood vessel that is compressing the nerve and places a cushion between the nerve and the blood vessel.
  • Percutaneous procedures: There are three types of percutaneous (through the skin) procedures, which can be used to damage the trigeminal nerve to block pain signals. These procedures typically result in some facial numbness.
    • Percutaneous radiofrequency rhizotomy, a procedure in which your neurosurgeon injects a needle into the nerve that is then heated to lessen nerve signals
    • Glycerol injection (percutaneous glycerol rhizotomy, PGR), a procedure in which your neurosurgeon injects glycerol into the nerve to damage it
    • Balloon compression, in which your neurosurgeon uses a balloon to put pressure on the nerve
  • Radiosurgery: Your neurosurgeon works with radiation therapists at Rush to deliver focused radiation on the trigeminal nerve to destroy the pain-causing nerve fibers.

Why choose Rush for trigeminal neuralgia care

  • Neurosurgeons at Rush have extensive experience treating TN using a variety of surgical procedures. This experience gives them a balanced view of all the surgical options, which allows them to find the best choice for each patient.
  • Rush offers TrueBeam Stx radiosurgery to treat trigeminal neuralgia. TrueBeam has an advanced computer-imaging system that compensates for small head movements, allowing patients to lie comfortably during the procedure.
  • The neurological sciences and neurological surgery programs at Rush are consistently ranked among the best in the country by U.S. News & World Report in its annual “Best Hospitals” issue.

Departments and programs that treat this condition