Brain Procedures

Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a painful nerve condition characterized by brief episodes of severe stabbing or shock-like pain on one side of the face. Normal activities that can trigger the pain include talking, chewing, toothbrushing, shaving, application of makeup, or even a breeze upon the face. The pain may occur frequently and some sufferers eventually experience an almost constant aching pain. The pain is felt along the trigeminal nerve which serves parts of the forehead, nose, cheek, jaw, and lips. It has three branches and pain is felt along one or more of the branches.

Also called tic douloureux, TN can occur at any age but is more common after age 50. Women are disproportionately affected. Normally caused by a blood vessel beating or rubbing against the nerve for facial sensation where it enters the brainstem, TN can also arise from a tumor pressing upon the nerve or from multiple sclerosis. Treatment begins with medication, but may ultimately require any of a number of surgical procedures or a specialized radiation technique known as radiosurgery. Peter Jannetta, MD, ScD, the neurosurgeon who invented the microvascular decompression procedure, trained David W. Lowry, MD, one of our Brain + Spine Center neurosurgeons, who performed many of these procedures with Dr. Jannetta personally over a seven-year neurosurgery residency.