Trigeminal Neuralgia Surgery: Microvascular Decompression & Radiosurgery
Trigeminal neuralgia causes brief, electric-shock-like facial pain triggered by chewing, talking, brushing teeth or a light touch. Hemifacial spasm causes involuntary twitching of one side of the face. Both are usually caused by a blood vessel pressing on a cranial nerve where it leaves the brainstem.
Medication (typically carbamazepine or oxcarbazepine) is the first treatment. When medication fails or side effects become intolerable, surgery can offer durable relief.
Symptoms
- Sudden, severe, stabbing facial pain lasting seconds
- Pain triggered by touch, wind, chewing or speaking
- Pain-free intervals between attacks
- For hemifacial spasm: twitching around the eye that spreads to the cheek and mouth
How it is diagnosed
Careful history is most important. High-resolution MRI (FIESTA/CISS sequences) looks for vascular compression and rules out tumors or multiple sclerosis.
Treatment options
Without surgery
Anticonvulsant medications; botulinum toxin injections for hemifacial spasm.
Surgical options Dr. Daggubati offers
- Microvascular decompression (MVD) through a small keyhole behind the ear
- Stereotactic radiosurgery to the trigeminal nerve
Common questions
How effective is microvascular decompression?
MVD offers the highest rate of long-term pain relief for classic trigeminal neuralgia and preserves facial sensation. Most patients wake up pain-free, though results vary.
Not sure this is you?
Bring your imaging and your story. A single visit usually clarifies what is going on and which options are realistic. Request an appointment or call (301) 718-9611.