How to relieve trigeminal neuralgia

Written by Chen Yu Fei
Neurosurgery
Updated on April 20, 2025
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For patients with trigeminal neuralgia, there are many methods to achieve pain relief. For example, in the early stages of the disease, treatment can be administered through oral medication. Taking appropriate medications can effectively relieve pain and also reduce the frequency and occurrence of trigeminal neuralgia attacks. At the same time, some physical therapies such as massage, tuina, physiotherapy, acupuncture, and electrotherapy can significantly alleviate the pain. Of course, to achieve complete cure, surgical methods are recommended for treatment. We generally advise patients to undergo microvascular decompression surgery, through which the vast majority of patients can achieve good therapeutic effects.

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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.

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Written by Li Pei
Neurosurgery
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How is trigeminal neuralgia treated?

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 Chen Yu Fei
Neurosurgery
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Trigeminal neuralgia symptoms display

Trigeminal neuralgia typically manifests as sudden, severe facial pain, most often occurring in areas such as the upper lip, nostril, or corner of the mouth. These areas are prone to forming trigger points, and touching or stimulating these points can provoke an episode of pain. Most often, pain attacks occur when the patient is talking or eating, causing sudden cessation of the activity. The patient may experience unilateral facial muscle spasms, and reactions such as frowning, clenching teeth, opening the mouth wide, covering the eyes, or vigorously rubbing the face with the palm of the hand, leading to rough, thickened skin and eyebrow hair loss.

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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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Does trigeminal neuralgia cause facial swelling?

Patients with trigeminal neuralgia may also experience slight swelling on their face, but it is not very obvious. This is because the nerve also has a special function, which is to provide nourishment. When the facial area innervated by the trigeminal nerve shows abnormal signs, the facial nerves in this area will become affected, leading to malnutrition and eventually causing facial swelling. However, such swelling is usually not very severe. If there are other factors involved, the swelling could become more serious. For instance, it could be due to a gum infection triggering trigeminal neuralgia, or pressure caused by other tumors. Therefore, the best approach is to visit a hospital promptly for relevant examinations to clarify the cause, which is the best for the patient.