Skip to main content
SpringerLink
Log in

Trigeminal Neuralgia

  • Chapter
Radiotherapy for Non-Malignant Disorders

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 2171 Accesses

Abstract

Trigeminal neuralgia (TN) is a disabling painful condition. It is characterized by sudden severe and intense attacks of stabbing or electrical-shock-like pain that are typically brief, lasting for a few seconds up to several minutes. TN pain is mostly unilateral, involving the innervation area of the trigeminal nerve. Each pain attack may come on spontaneously or be triggered by certain stimuli, usually in the affected areas of the face. Common triggers may include simple touch, talking, eating, drinking, chewing, tooth brushing and hair combing. In contrast, pinching or pressing these trigger points will not usually cause TN pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Abdennebi B, Mahfouf L, Nedjahi T (1997) Long-term results of percutaneous compression of the Gasserian ganglion in trigeminal neuralgia. Stereotact Funct Neurosurg 68:190–195

    Article  PubMed  CAS  Google Scholar 

  2. Ameli NO (1965) Avicenna and trigeminal neuralgia. JNeurol Sci 2:105–107

    Article  CAS  Google Scholar 

  3. Arias MJ (1986) Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia. A prospective study of 100 cases. J Neurosurg 65:32–36

    PubMed  CAS  Google Scholar 

  4. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077–1083

    Article  PubMed  Google Scholar 

  5. Boecher-Schwarz HG, Bruehl K, Kessel, Guenthner M, Pernetczky A, Stoeter P (1998) Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings. Neuroradiology 40:88–95

    Article  PubMed  CAS  Google Scholar 

  6. Brisman R, Mooij R (2000) Gamma knife radiosurgery for trigeminal neuralgia: dose-volume histograms of the brainstem and trigeminal nerve. Neurosurgery 93 [Suppl 3]:155–158

    Google Scholar 

  7. Brisman R (2000) Gamma knife radiosurgery for primary management for trigeminal neuralgia. J Neurosurg 93 [Suppl 3]:159–61

    PubMed  Google Scholar 

  8. Brisman R (2004) Gamma knife surgery with a dose of 75 to 76.8 Gy for trigeminal neuralgia. J Neurosurg 100:848–854

    PubMed  Google Scholar 

  9. Brisman R (2003) Repeat gamma knife radiosurgery for trigeminal neuralgia. Stereotact Funct Neurosurg 81:43–49

    Article  PubMed  Google Scholar 

  10. Burchiel KJ, Clarke H, Haglund M, Loeser JD (1988) Longterm efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg 69:35–38

    PubMed  CAS  Google Scholar 

  11. Campbell FG, Graham JG, Zilkha KJ (1966) Clinical trial of carbamazepine (Tegretol) in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 29:265–267

    Article  PubMed  CAS  Google Scholar 

  12. Chen JC, Girvigian M, Greathouse H, Miller M, Rahimian J (2004) Treatment of trigeminal neuralgia with linear accelerator radiosurgery: initial results. J Neurosurg 101 [Suppl 3]:346–350

    PubMed  Google Scholar 

  13. Cheng TMW, Cascino TL, Onofrio BM (1993) Comprehensive study of diagnosis and treatment of trigeminal neuralgia secondary to tumours. Neurology 43:2298–2302

    PubMed  CAS  Google Scholar 

  14. Cheuk AV, Chin LS, Petit JH, Herman JM, Fang HB, Regine WF (2004) Gamma knife surgery for trigeminal neuralgia: outcome, imaging, and brainstem correlates. Int J Radiat Oncol Biol Phys 60:537–541

    PubMed  Google Scholar 

  15. Clifford DR, Trotter IL (1984) Pain in multiple sclerosis. Arch Neurol 41:1270–1272

    PubMed  CAS  Google Scholar 

  16. Delitala A, Brunori A, Chiappetta F (2001) Microsurgical posterior fossa exploration for trigeminal neuralgia: a study on 48 cases. Minim Invasive Neurosurg 44:152–156

    Article  PubMed  CAS  Google Scholar 

  17. Flickinger JC, Pollock BE, Kondziolka D, Phuong LK, Foote RL, Stafford SL, Lunsford LD (2001) Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? A prospective double-blind, randomized study. Int J Radiat Oncol Biol Phys 51:449–454

    PubMed  CAS  Google Scholar 

  18. Fraioli F, Esposito V, Guidetti B, Cruccu G, Mangfredi M (1989) Treatment of trigeminal neuralgia by thermocoagulation, glycerolization, and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets: long-term results and therapeutic protocol. Neurosurgery 24:239–245

    Article  PubMed  CAS  Google Scholar 

  19. Fujimaki T, Fukushima T, Miyazaki S (1990) Percutaneous retrogasserian glycerol injection in the management of trigeminal neuralgia: long-term results. J Neurosurg 73:212–216

    PubMed  CAS  Google Scholar 

  20. Gerbi BJ, Higgins PD, Cho KH, Hall WA (2004) Linacbased stereotactic radiosurgery for treatment of trigeminal neuralgia. J Appl Clin Med Phys 5:80–92. Epub 2004 Jul 1

    Article  PubMed  Google Scholar 

  21. Goss BW, Frighetto L, DeSalles AA, Smith Z, Solberg T, Selch M (2003) Linear accelerator radiosurgery using 90 Gy for essential trigeminal neuralgia: results and dose volume histogram analysis. Neurosurgery 53:823–828; discussion 828-830

    Article  PubMed  Google Scholar 

  22. Goto F, Ishizaki K, Yoshikawa D, Obata H, Arii H, Terada M (1999) The long lasting effects of peripheral nerve blocks for trigeminal neuralgia using a high concentration of tetracaine dissolved in bupivacaine. Pain 79:101–103

    Article  PubMed  CAS  Google Scholar 

  23. Gregg JM, Small EW (1986) Surgical management of trigeminal pain with radiofrequency lesions of peripheral nerve. J Oral Maxillofac Surg 44:122–125

    Article  PubMed  CAS  Google Scholar 

  24. Håkansson S (1981) Trigeminal neuralgia treated by the injection into the trigeminal cistern. Neurosurgery 9:638–646

    Google Scholar 

  25. Harris W (1950) Rare forms of paroxysmal trigeminal neuralgia and their relation to disseminated sclerosis. BMJ 2:1015–1019

    Article  PubMed  CAS  Google Scholar 

  26. Henson CF, Goldman HW, Rosenwasser RH, Downes MB, Bednarz G, Pequignot EC, Werner-Wasik M, Curran WJ, Andrews DW (2005) Glycerol rhizotomy versus gamma knife radiosurgery for the treatment of trigeminal neuralgia: an analysis of patients treated at one institution. Int J Radiat Oncol Biol Phys 63(l):82–90

    PubMed  Google Scholar 

  27. Herman JM, Petit JH, Amin P, Kwok Y, Dutta PR, Chin LS (2004) Repeat gamma knife radiosurgery for refractory or recurrent trigeminal neuralgia: treatment outcomes and quality-of-life assessment. Int J Radiat Oncol Biol Phys 59(1):112–116

    PubMed  Google Scholar 

  28. Jacobs LD, Beck RW, Simon JH, Kinkel RP, Brownscheidle CM, Murray TJ, Simonian NA, Slasor PJ, Sandrock AW, the CHAMPS Study Group (2000) Intramuscular interferon beta-la therapy initiated during a first demyelinating event in multiple sclerosis. N Engl J Med 343:898–904

    Article  PubMed  CAS  Google Scholar 

  29. Jannetta PJ (1977) Treatment of trigeminal neuralgia by suboccipital and transtentorial cranial operation. Clin Neurosurg 24:538–549

    PubMed  CAS  Google Scholar 

  30. Kanner AA, Neyman G, Suh JH, Weinhous MS, Lee SY, Barnett GH (2004) Gamma knife radiosurgery for trigeminal neuralgia: comparing the use of a 4-mm versus concentric 4-and 8-mm collimators. Stereotact Funct Neurosurg 82:49–57

    Article  PubMed  Google Scholar 

  31. Katusic S, Beard CM, Bergstralh E, Kurland LT (1990) Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol 27:89–95

    Article  PubMed  CAS  Google Scholar 

  32. Killian JM, Fromm GH (1968) Carbamazepine in the treatment of neuralgia. Arch Neurol 19:129–136

    PubMed  CAS  Google Scholar 

  33. Kolluri S, Heros RC (1984) Microvascular decompression for trigeminal neuralgia. A 5-year follow-up study. Surg Neurol 22:235–240

    Article  PubMed  CAS  Google Scholar 

  34. Kondo A (1997) Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm. Neurosurgery 40:46–52

    Article  PubMed  CAS  Google Scholar 

  35. Kondziolka D, Lunsford LD, Flickinger JC, Young RF, Vermeulen S, Duma CM, Jacques DB, Rand RW, Regis J, Peragut JC, Manera L, Epstein MH, Lindquist CJ (1996) Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit. Neurosurgery 84:940–945

    CAS  Google Scholar 

  36. Kondziolka D, Lunsford LD, Flickinger JC (2002) Stereotactic radiosurgery for the treatment of trigeminal neuralgia. Clin J Pain 18:42–47

    Article  PubMed  Google Scholar 

  37. Kondziolka D, Perez B, Flickinger JC, Habeck M, Lunsford LD (1998) Gamma knife radiosurgery for trigeminal neuralgia: results and expectations. Arch Neurol 55:1524–1529

    Article  PubMed  CAS  Google Scholar 

  38. Kondziolka D (1999) Functional neurosurgery. Neurosurgery 44:12–20

    Article  PubMed  CAS  Google Scholar 

  39. Leandri M, Eldridge P, Miles J (1998) Recovery of nerve conduction following microvascular decompression for trigeminal neuralgia. Neurology 51:1641–1646

    PubMed  CAS  Google Scholar 

  40. Lichtor T, Mullan JF (1990) A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 72:49–54

    PubMed  CAS  Google Scholar 

  41. Massager N, Lorenzoni J, Devriendt D, Desmedt F, Brotchi J, Levivier M (2004) Gamma knife surgery for idiopathic trigeminal neuralgia performed using a far-anterior cisternal target and a high dose of radiation. J Neurosurg 100:597–605

    PubMed  Google Scholar 

  42. McNatt SA, Yu C, Giannotta SL, Zee CS, Apuzzo ML, Petrovich Z (2005) Gamma knife radiosurgery for trigeminal neuralgia. Neurosurgery 56(6):1295–1301

    Article  PubMed  Google Scholar 

  43. Meaney JF, Eldridge PR, Dunn LT, Nixon TE, White-house G, Miles JB (1995) Demonstration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. Comparison of surgical findings in 52 consecutive operative cases. J Neurosurg 83:799–805

    PubMed  CAS  Google Scholar 

  44. Mullan S, Lichtor T (1983) Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59:1007–1012

    PubMed  CAS  Google Scholar 

  45. Nicol CF (1969) A 4-week double blind study of tegretol in facial pain. Headache 9:54–57

    Article  PubMed  CAS  Google Scholar 

  46. North RB, Kidd DH, Piantadosi S, Carson BS (1990) Percutaneous retrogasserian glycerol rhizotomy. Predictors of success and failure in treatment of trigeminal neuralgia. J Neurosurg 72:851–856

    PubMed  CAS  Google Scholar 

  47. Nurmikko TJ, Eldridge PR (2001) Trigeminal neuralgia — pathophysiology, diagnosis and current treatment. Br J Anaesth, vol 87, no 1, 117–132

    Article  PubMed  CAS  Google Scholar 

  48. Pollock BE, Foote RL, Stafford SL, Link MJ, Gorman DA, Schomberg PJ (2000) Results of repeated gamma knife radiosurgery for medically unresponsive trigeminal neuralgia. J Neurosurg 93 [Suppl 3]:162–164

    PubMed  Google Scholar 

  49. Pollock BE, Phuong LK, Foote RL, Stafford SL, Gorman DA (2001) High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction. Neurosurgery 49:58–62; discussion 62-64

    Article  PubMed  CAS  Google Scholar 

  50. Pollock BE, Phuong LK, Gorman DA, Foote RL, Stafford SL (2002) Stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 97:347–53

    PubMed  Google Scholar 

  51. Rappaport ZH, Devor M (1994) Trigeminal neuralgia: the role of self-sustaining discharge in the trigeminal ganglion. Pain 56:127–138

    Article  PubMed  CAS  Google Scholar 

  52. Rhoton AL (2000) The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach. Neurosurgery 47 [Suppl]:S93–129

    Article  Google Scholar 

  53. Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL (2000) Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47(4):1013–1019

    PubMed  CAS  Google Scholar 

  54. Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL (2000) Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47(4):1013–1019

    PubMed  CAS  Google Scholar 

  55. Rose FC (1999) Trigeminal neuralgia. Arch Neurol 56:1163–1164

    Article  PubMed  CAS  Google Scholar 

  56. Saini SS (1987) Retrogasserian glycerol injection therapy in trigeminal neuralgia. J Neurol Neurosurg Psychiatry 50:1536–1538

    Article  PubMed  CAS  Google Scholar 

  57. Shaya M, Jawahar A, Caldito G, Sin A, Willis BK, Nanda A (2004) Gamma knife radiosurgery for trigeminal neuralgia: a study of predictors of success, efficacy, safety, and outcome at LSUHSC. Surg Neurol 61(6):529–534

    Article  PubMed  Google Scholar 

  58. Sheehan J, Pan HC, Stroila M, Steiner L (2005) Gamma knife surgery for trigeminal neuralgia: outcomes and prognostic factors. J Neurosurg 102:434–441

    Article  PubMed  Google Scholar 

  59. Shetter AG, Rogers CL, Ponce F, Fiedler JA, Smith K, Speiser BL (2002) Gamma knife radiosurgery for recurrent trigeminal neuralgia. J Neurosurg 97 [5 Suppl]:536–538

    PubMed  Google Scholar 

  60. Smith ZA, De Salles AA, Frighetto L, Goss B, Lee SP, Selch M, Wallace RE, Cabatan-Awang C, Solberg T (2003) Dedicated linear accelerator radiosurgery for the treatment of trigeminal neuralgia. J Neurosurg 99:511–516

    PubMed  Google Scholar 

  61. Stajic Z, Juniper RP, Todorovic L (1991) Peripheral streptomycin/lidocaine injections versus lidocaine alone in the treatment of idiopathic trigeminal neuralgia. A double blind controlled trial. J Craniomaxillofac Surg 18:243–246

    Google Scholar 

  62. Steiger HJ (1991) Prognostic factors in the treatment of trigeminal neuralgia. Analysis of a differential therapeutic approach. Acta Neurochir 113:11–17

    Article  CAS  Google Scholar 

  63. Sweet WH, Wepsic JG (1974) Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibres. Part 1: trigeminal neuralgia. J Neurosurg 39:143–156

    Google Scholar 

  64. Tawk RG, Duffy-Fronckowiak M, Scott BE, Alberico RA, Diaz AZ, Podgorsak MB, Plunkett RJ, Fenstermaker RA (2005) Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response. J Neurosurg 102(3):442–449

    PubMed  Google Scholar 

  65. Urgosik D, Liscak R, Novotny J Jr, Vymazal J, Vladyka V (2005) Treatment of essential trigeminal neuralgia with gamma knife surgery. J Neurosurg [Suppl] 102:29–33

    PubMed  Google Scholar 

  66. Waltz TA, Dalessio DJ, Copeland B, Abbott G (1989) Percutaneous injection of glycerol for the treatment of trigeminal neuralgia. Clin J Pain 5:195–198

    Article  PubMed  CAS  Google Scholar 

  67. Wilkinson HA (1999) Trigeminal nerve peripheral branch phenol/glycerol injections for tic douloureux. J Neurosurg 90:828–832

    PubMed  CAS  Google Scholar 

  68. Young RF, Vermulen S, Posewitz A (1998) Gamma knife radiosurgery for the treatment of trigeminal neuralgia. Stereotact Funct Neurosurg 70 [Suppl 1]:192–199

    Article  PubMed  Google Scholar 

  69. Young RF, Vermeulen SS, Grimm P, Blasko J, Posewitz A (1997) Gamma Knife radiosurgery for treatment of trigeminal neuralgia: idiopathic and tumor related. Neurology 48(3):608–614

    PubMed  CAS  Google Scholar 

  70. Young RF (1988) Glycerol rhizolysis in the treatment of trigeminal neuralgia. J Neurosurg 69:39–45

    PubMed  CAS  Google Scholar 

  71. Zakrewska JM (1995) Trigeminal neuralgia. WB Saunders, London

    Google Scholar 

  72. Zheng LG, Xu DS, Kang CS, Zhang ZY, Li YH, Zhang YP, Liu D, Jia Q (2001) Stereotactic radiosurgery for primary trigeminal neuralgia using the Leksell gamma unit. Stereotact Funct Neurosurg 76:29–35

    Article  PubMed  CAS  Google Scholar 

  73. Zorman G, Wilson CB (1984) Outcome following microsurgical vascular decompression or partial sensory rhizotomy in 125 cases of trigeminal neuralgia. Neurology 34:1362–1365

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology and Therapeutic Radiology, Alfried Krupp Hospital, Alfried Krupp Straße 21, 45117, Essen, Germany

    Michael Heinrich Seegenschmiedt MD (Professor) & Manfred Körner MD

  2. Department of Radiation Oncology and Radiation Therapy, Robert-Janker-Clinic, Villenstrasse 4-8, 53129, Bonn, Germany

    Mared Attassi MD

Authors
  1. Mared Attassi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Heinrich Seegenschmiedt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manfred Körner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology and Therapeutic Radiology, Alfried-Krupp-Hospital, Alfried-Krupp-Strasse 21, Postfach 10 22 43, 45117, Essen, Germany

    Michael Heinrich Seegenschmiedt MD (Professor) (Professor)

  2. Strahlenklinik Klinikum Duisburg, Zu den Rehwiesen 9, 47055, Duisburg, Germany

    Hans-Bruno Makoski MD (Professor) (Professor)

  3. Department of Radiation Biology, St. Bartolomew’s Medical College, Charterhouse Square, London, EC1M 6BQ, UK

    Klaus-Rüdiger Trott MD (Professor) (Professor)

  4. Hylda Cohn/American Cancer Society, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

  5. College of Medicine, Drexel University, Broad & Vine Sts., Mail Stop 200, Philadelphia, PA, 19102-1192, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Attassi, M., Seegenschmiedt, M.H., Körner, M. (2008). Trigeminal Neuralgia. In: Seegenschmiedt, M.H., Makoski, HB., Trott, KR., Brady, L.W. (eds) Radiotherapy for Non-Malignant Disorders. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68943-0_38

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-68943-0_38

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-62550-6

  • Online ISBN: 978-3-540-68943-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation