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What Is Trigeminal Neuralgia?

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Imagine suffering from constant pain on one side of your face for years together, with simple actions





About The Author



Dr. K.B. Mallya was born in Mangalore and after graduating from Kasturba Medical College, Manipal, he completed his Neurosurgical Training in Canada. Then he accepted a four year Fellowship at Memorial Sloan-Kettering Cancer Center in New York. At present Dr Mallya is the Chief of Neurosurgery at HOSMAT, Bangalore. 

such as talking, eating, brushing teeth, or even a light breeze bringing on the pain.

This was the condition a middle-aged woman was afflicted with for five years before she was cured after complex Neurosurgery at HOSMAT (Hospital for Orthopaedics, Sports Medicine, Arthritis and Accident Trauma) in Bangalore.


The woman was afraid to even go out for a walk or talk for long, fearing the pain, according to Dr. Kasargod B. Mallya, Chief of Neurosurgery at the hospital. She had visited several doctors and treated with nerve blocks without relief. At HOSMAT, she was diagnosed as suffering from “Trigeminal Neuralgia,” a condition which causes severe facial pain due to compression of the trigeminal nerve by a blood vessel.


Dr. Mallya says he and associate N.C. Prakash conducted a micro vascular decompression which lasted for about 4 hours, where the compression of the trigeminal nerve by a blood vessel was released with careful and precise dissection under a microscope. The blood vessels were separated from the nerve, and same day, the patient was free from the pain she had suffered for years.


Explaining the disorder, Dr. Mallya says Trigeminal Neuralgia is a condition that affects the fifth cranial nerve, one of the largest in the head. This nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes.



Intraoperative photographs show an arterial loop compressing the 5th cranial nerve (A; TN = trigeminal nerve), separation of the artery from the nerve (B), and placement of Teflon sponge (T) between the artery and the nerve (C).


What Is Trigeminal Neuralgia?



TN (Trigeminal Neuralgia / tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed – lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw. 


By many, it’s called the “suicide disease”.  A less common form of the disorder called “Atypical Trigeminal Neuralgia” may cause less intense, constant, dull burning or aching pain, sometimes with occasional electric shock-like stabs.   Both forms of the disorder most often affect one side of the face, but some patients experience pain at different times on both sides.  Onset of symptoms occurs most often after age 50, but cases are known in children and even infants. Something as simple and routine as brushing the teeth, putting on makeup or even a slight breeze can trigger an attack, resulting in sheer agony for the  individual.


Trigeminal neuralgia (TN) is not fatal, but it is universally considered to be the most painful affliction known to medical practice.  Initial treatment of TN is usually by means of anti-convulsant drugs, such as Tegretol or  Neurontin.  Some anti-depressant drugs also have significant pain relieving effects.  Should medication be ineffective or if it produces undesirable side effects, neurosurgical procedures are available to relieve pressure on the nerve or to reduce nerve sensitivity.  Some patients report having reduced or relieved pain by means of alternative medical therapies such as acupuncture, chiropractic adjustment, self-hypnosis or meditation.

Author: Dr. K.B. Mallya


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