trigeminal neuralgia scope

Written by Chen Yu Fei
Neurosurgery
Updated on August 31, 2024
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The range of trigeminal neuralgia attacks is usually located in the sensory area of the trigeminal nerve root, broadly covering both sides of the patient's nostrils and around the corners of the mouth. The nature of the pain is quite severe, often described as knife-like pain or burning pain. The duration of each pain episode varies, often starting and stopping suddenly. Around the pain area, fixed trigger points are likely to form. Accidentally touching these trigger points while brushing teeth, washing faces, or rinsing mouths can often trigger an attack of trigeminal neuralgia. Over time, due to repeatedly triggering the pain by touching these points, patients may become afraid to wash their faces or brush their teeth, and may experience facial muscle numbness or atrophy.

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Written by Guo Zhi Fei
Neurosurgery
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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.

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Written by Li Pei
Neurosurgery
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What are the symptoms of trigeminal neuralgia?

The clinical symptoms of trigeminal neuralgia are mainly characterized by severe, paroxysmal pain in the area of the face distributed by the trigeminal nerve, typically affecting one side. The pain can affect one, two, or all three branches of the trigeminal nerve. The pain is episodic, resembling cutting, electric shocks, and is sudden in onset and cessation, making it unbearable for the patient. In some patients, actions such as eating, washing the face, or brushing teeth can trigger the pain. Most patients have trigger points, commonly located near the nostrils, corners of the mouth, or upper lip.

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Written by Li Pei
Neurosurgery
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Does trigeminal neuralgia require craniotomy?

If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate. If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.

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Written by Liu Hong Mei
Neurology
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Is occipital neuralgia the same as trigeminal neuralgia?

Occipital neuralgia and trigeminal neuralgia are different; these are two distinct diseases with different onset times, affected areas, and pain characteristics. Occipital neuralgia generally occurs in the back of the head and is associated with cervical spondylosis, neck muscle tension, spasms, injury, trauma, and inflammation, typically triggering pain in the distribution area of the greater occipital nerve. Trigeminal neuralgia generally affects the distribution area of the trigeminal nerve, causing very intense pain, which may be like lightning or a burning sensation. It is typically triggered by washing the face, brushing teeth, or touching and can start and stop suddenly.

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Written by Gao Yi Shen
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Trigeminal neuralgia should register for which department?

The department for registering trigeminal neuralgia depends on the distribution of departments in the local hospital. Most commonly, registration is done in the department of functional neurosurgery. However, different hospitals may have different levels of specialization and may employ varying treatment methods which require different departments. For instance, initially, one can register at the department of neurosurgery for oral medication adjustment, usually with carbamazepine. If there is no significant improvement later on, one may register with the department of pain management or anesthesiology for nerve block treatment. Due to the detailed specialization in some hospitals, it might also be necessary to consult other departments. If there is still no effective outcome, it is necessary to register at the department of neurosurgery for surgical treatment to fundamentally address the disease.