I have been diagnosed with Trigeminal Neuralgia and will need treatment.

1. Percutaneous needle rhizotomy (PNR) is a day procedure and usually the patient goes home later that day or the following morning. A specially designed needle is guided using X-ray and CT navigation to where the trigeminal nerve exits the skull. The nerve is destroyed using a chemical (glycerol), heat (radiofrequency electrocoagulation) or a balloon compression. Most patients get good pain relief after the procedure, however rates of recurrence are significant over the first 5 years. The procedure may be repeated.

2. Microvascular decompression (MVD) The patient is usually required to stay in hospital for 2- 3 days. This procedure involves making a small opening through the bone behind the ear. The blood vessels that are pressing against the trigeminal root are relocated or removed to stop the nerve from malfunctioning. Mose patients wake up with complete or significant pain relief and are weaned from their medication over the next 1-2 weeks. MDV offers the greatest chance of long-lasting pain relief with 70-80% of patients remaining pain free after 10 years.

3. Stereotactic radiosurgery is performed by a radition specialist as a day procedure and avoids surgery in some patients. SRS involves the surgeon directing a focused dose of radiation to the root of the trigeminal nerve to damage the nerve and reduce or eliminate the pain. It is helpful for patients who cannot come off blood thinners or whom the above procedures are deemed too risky. The major drawbacks to SRS is the delayed onset of pain relief, often taking 1-3 months before benefit is seen.