Trigeminal neuralgia is a condition affecting the trigeminal nerve, located in the central nervous system. This long-term disorder causes intense episodic pain in the areas of the face, along the pathway of any of the three branches of the trigeminal nerve (although the most frequently affected area is the jaw).
Vascular microdecompression is a widely accepted neurosurgical technique with a high success rate that resolves the main cause of trigeminal pain, which is contact with the superior cerebellar artery. An opening is made in the skull behind the ear, and, by means of vascular dissection, prosthetic material is placed between the artery and the nerve, cushioning the latter and eliminating or reducing pain. In the hands of an expert neurosurgeon, the percentage of success is very high, and the solution is permanent; therefore, this is the procedure of first choice.
There are other techniques for those patients who cannot undergo vascular microdecompression surgery due to high surgical risk or other causes of trigeminal neuralgia, such as Herpes virus. Examples of these are radiofrequency and balloon compression of the Gasser ganglion (which is part of the trigeminal nerve).
These techniques are performed by puncture through a natural hole at the base of the skull, with intraoperative X-ray guidance. These procedures can be performed with sedation, and although they are not as effective in the long term, they can provide relief for patients who cannot undergo other interventions.
As we have already mentioned, the main cause of this condition is the irritation caused by compression of the trigeminal nerve by the superior cerebellar artery inside the skull, although it can also be related to tumors, Herpes virus infection or multiple sclerosis. Usual treatment begins with pharmacological therapy, with carbamazepine being the drug of first choice. However, when this medical treatment is not effective or sufficient, there are other means to relieve pain.
At Instituto Clavel we have all the latest tools and technology, including new generation systems, to carry out these surgical interventions, and all our staff has extensive experience in their use and the treatment of trigeminal neuralgia in all its stages.