Trigeminal Neuralgia: Face Pain & Treatment Options

Trigeminal Neuralgia: Face Pain & Treatment Options

By Christopher Loiselle, MD
Radiation Oncologist

October 7th was Trigeminal Neuralgia Awareness Day and for many reading or hearing the stories, like the story on, this condition may not be familiar.  However, for those suffering from trigeminal neuralgia, every day can be challenging.

Facial pain in Trigeminal Neuralgia is characterized by episodes of intense pain lasting from a few seconds to hours at a time. The attacks are often described as electric shock like, burning, pressing, crushing,  or shooting pain. Patients describe areas on the face as sensitive to the point that even a gentle breeze of wind can trigger an episode of pain.

Once diagnosed, trigeminal neuralgia can be treated with medications, surgical procedures or the Gamma Knife.  The Gamma Knife is an outpatient procedure precisely directing 192 beams of radiation to the root of the trigeminal nerve.  Most patients have a dramatic improvement in their pain.

C. R.
I have had trigeminal neuralgia for 18 years. I was diagnosed at age 19, which is highly unusual, as it typically occurs in older patients. After approximately 15 years of treating it with medication, my husband and I decided we would like to have children. Because tegretol can cause severe birth defects, I had to get off of the medication. I sought after the best and most experience staff I could find in my area. Time and time again, Swedish Medical Center came up, and specifically, Dr. Ryder Gwinn and his team.

I had a microvascular decompression done in 2011, and it was successful for approximately 9 months. However, the pain returned, and I went back to Swedish for a Gamma Knife treatment. My physicians for that procedure were Dr. Gwinn and Dr. Loiselle. The treatment was successful - perfect, in fact, and I was very lucky in that I had zero numbness afterward. My pain was there for approximately 6 weeks after the treatment (gradually decreasing in intensity and frequency as the 6 weeks went along). After 6 weeks, I had no pain, I still had all of the feeling in my face, and it lasted for almost 2 years! Anyone with TN will tell you that handing someone 2 years free of pain, is a present that you don't dare dream of. I have recently had the pain return, and I am in the process of scheduling my second gamma knife treatment with Swedish. There are always risks (with any procedure), and I may not be as lucky this time around - I could have some facial numbing, but I'd rather have some numbing than the pain.

Trigeminal Neuralgia is a horrible disease, and I feel for anyone who has to deal with it. However, the neurosurgery and radiology teams at Swedish are truly top-notch. I would not hesitate to have anything done there, and I literally trust them with my life. If I have a family member or friend suddenly stricken with this disease, after I tell them how sorry I am for them, the very next thing I would recommend is for them to go to Swedish. They care about their patients and want the very best for us. Dr. Gwinn is known all over the U.S. I now live on the East Coast side, and all of my neurosurgeons here have heard of him and speak highly of him.
8/6/2014 8:00:52 AM
Jamie Applington
Dr. Newell performed the decompression surgery in March, saved my life. I had lost 60 pounds, 3 teeth, and almost my family and my life. This crap is nasty. One can not come close to understanding it unless one had had to deal with it. Patients, do what you can to get treatment. Swedish is the best around, and the team there is the best. They are caring, compassionate and love what they do.
10/18/2013 9:52:52 AM
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