How is trigeminal neuralgia treated?

Written by Li Pei
Neurosurgery
Updated on April 26, 2025
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After the onset of trigeminal neuralgia, medication is the first choice of treatment. If the effect of medication is poor, surgical treatment can be considered. There are two methods of surgical treatment. One is radiofrequency treatment, which physically destroys the trigeminal nerve but often relapses after surgery.

The other method is microvascular decompression surgery of the trigeminal nerve under a microscope. This surgery requires craniotomy under general anesthesia. Under the microscope, the trigeminal nerve and the blood vessel pressing on it are identified, and then a special material is used to separate the two, so the blood vessel cannot irritate the trigeminal nerve, and thus, the pain is alleviated.

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Written by Gao Yi Shen
Neurosurgery
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Trigeminal neuralgia?

Trigeminal neuralgia is not uncommon in clinical settings; pain can often occur due to compression by blood vessels or tumor tissues. In addition, infections that irritate the trigeminal nerve can also cause pain. Therefore, it is essential to make assessments based on the specific conditions. In clinical practice, the initial treatment for trigeminal neuralgia typically involves oral medications. If there is no significant improvement with oral medications, further comprehensive examinations are necessary. Treatment options may include sphenopalatine ganglion block technique, microvascular decompression surgery, and craniotomy tumor removal surgery, among other measures. Thus, for trigeminal neuralgia, there are various treatment options available that can potentially provide significant relief. (The use of medications should be under the guidance of a doctor)

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Written by Gao Yi Shen
Neurosurgery
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Is trigeminal neuralgia easy to treat?

Whether trigeminal neuralgia is easy to treat must be judged based on the situation at the time. The vast majority of patients with trigeminal nerve pain can find a corresponding cause, such as compression by blood vessels, tumors, or infection factors. For vascular compression, microvascular decompression surgery can be adopted for treatment. For tumor compression, craniotomy and tumor resection can be adopted for treatment. For some infectious factors, treatment such as anti-infection and hormones can be adopted. These are relatively easier to treat, and most can have a very obvious prognosis. However, there are also cases, such as trigeminal neuralgia where no specific cause has been found, called primary trigeminal neuralgia, where active complete treatment is not possible, and only certain methods can be used to alleviate the general symptoms of the patient and reduce their suffering.

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Written by Li Pei
Neurosurgery
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Does trigeminal neuralgia require craniotomy?

If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate. If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.

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Written by Jiang Fang Shuai
Neurosurgery
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Is cold compress effective for trigeminal neuralgia?

Trigeminal neuralgia is a type of intense recurring pain in the facial areas distributed by the trigeminal nerve. When an attack occurs, the pain is unbearable for the patient. Clinically, besides immediately taking medication or opting for surgical treatments after stabilization, applying a cold compress can also alleviate symptoms. Placing a cold towel on the painful facial areas can relieve spasms and pain, improve local swelling, raise the pain threshold, and subsequently reduce the sensation of pain.

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Written by Gao Yi Shen
Neurosurgery
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Trigeminal neuralgia prodrome

Trigeminal neuralgia does not have very obvious precursors. This is because trigeminal neuralgia often occurs suddenly, especially with the concept of trigger points. That is to say, once the trigger point is activated, it immediately induces pain without any warning signs. Trigger points vary from person to person, usually located primarily on the cheek. Patients who frequently suffer from trigeminal neuralgia often know these areas. Typically, the pain occurs during activities like brushing teeth with cold water or chewing hard foods such as peanuts or walnuts, triggering severe pain instantly. Thus, in the case of trigeminal neuralgia, there are no precursors, only immediate triggers and immediate pain.