Facial Pain

How effective is the surgical management of facial pain (Trigeminal Neuralgia)?

Trigeminal Neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from face to brain.

In the presence of trigeminal neuralgia, even mild stimulation of the face, such as from brushing teeth or putting on makeup, may trigger an excruciating pain. Patient experience episodes of severe, shooting or jabbing pain that may feel like an electric shock.

Trigeminal Neuralgia is not a new disease and indeed first documented case was found in the writings of Galen, Aretaeus of Cappadocia (born circa AD 81) but John Fothergill gave the first full and accurate description of trigeminal neuralgia (Also known as Fothergill’s disease) in 1773.

Although the symptoms associated with trigeminal neuralgia have been well documented, the root cause of this disease initially eluded most surgeons. Early remedies were haphazard because of a lack of understanding about the condition, but over the last few decades, both medical and procedural therapies were established for the treatment of trigeminal neuralgia.

These treatments include a variety of medications, percutaneous chemoneurolysis, balloon compression, radiofrequency lesioning, stereotactic radiosurgery, and open rhizotomy and microvascular decompression.

Because of the variety of treatment options available, having trigeminal neuralgia doesn’t necessarily mean the patient is doomed to a life of pain.

Although each treatment has its own limitations, with a good case selection between 80 and 95 per cent of patients experience complete or partial relief after the procedure.

I have been treating Trigeminal Neuralgia in England where I acquired satisfactory experience in this field and since I have joined Neuron, managed to use the state of art equipment and instruments to offer this kind of operations at Brisbane Private Hospital.

I have been using my experience in lateral skull base neurosurgery to achieve satisfactory exposure and decompression of trigeminal nerve through a small opening in the skull and using endoscope when needed to get the advantage of expanded vision endoscope can provide.

I also offer percutaneous radiofrequency lesioning or balloon compression of the trigeminal nerve which are minimally invasive procedures with a high success rate in a selected group of patients. I am using navigation guidance for these procedures in addition to a traditional X-Ray which would increase the accuracy and potentially improve the outcome.

Dr Ali Alavi

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