Gamma Knife Radiosurgery is the Best Treatment for Trigeminal Neuralgia
Also known as tic douloureux, Trigeminal Neuralgia (TN) is a pain syndrome which is recognizable by the patient’s history alone. This is basically a neurological condition characterized by intermittent facial pain that is one-sided in nature. Trigeminal neuralgia pain typically involves one side of face. Moreover, physical examination findings will typically reveal nothing & which says that everything is normal, although mild touch or loss of pin perception are described in central areas of the face. This in fact is a significant sensory loss suggesting that pain syndrome is secondary & therefore requiring high-resolution neuro-imaging in order to exclude some other causes of facial pain.
Medical Treatment of Trigeminal Neuralgia
Goal of medical treatment of trigeminal neuralgia, however, is only to reduce pain. Carbamazepine (Tegretol) medication is regarded as the most effective medical treatment of trigeminal neuralgia. Other agents which are found to benefit trigeminal neuralgia patients are Klonazepin, Trileptol, gabapentin (Neurontin), baclofen & phenytoin (Dilantin).
Surgical Treatment of Trigeminal Neuralgia
All trigeminal neuralgia patients should undergo MRI prior to considering surgery as treatment. Close attention should also be given to posterior fossa during studies. This is generally required in order to rule out other causes of trigeminal nerve compression like large ecstatic vessels, mass lesions or other vascular malformations. Surgical options for trigeminal neuralgia generally include ablation or peripheral nerve blocks, craniotomy followed by microvascular decompression, gasserian ganglion, retrogasserian ablative procedures & gamma knife stereotactic radiosurgery.
Stereotactic Radiosurgery Treatment of Trigeminal Neuralgia
Stereotactic radiosurgery procedure, like gamma knife radiosurgery, is performed by delivering high doses of ionizing radiation within a single treatment session. This procedure utilizes multiple beams of radiation which precisely focus at a target within the body. While efficacy of gamma knife radiosurgery is well documented, this is a least invasive treatment procedure for trigeminal neuralgia & is one of the best treatment options for patients with high-risk medical illnesses, co-morbidities or pain refractory to prior surgical procedures. However, main complication following trigeminal neuralgia radiosurgery treatment is new facial sensory symptoms which are caused due to partial trigeminal nerve injury causing facial numbness lasting longer than 6 months. However, lack of mortality along with low risk of sensory disturbance in face, even after repeated radiosurgery procedures, advocate use of primary or secondary radiosurgery as the best treatment for trigeminal neuralgia. Moreover, repeated radiosurgery still remains an acceptable trigeminal neuralgia treatment option for patients who have failed to benefit from other therapeutic alternatives.
Affordable Treatment for Trigeminal Neuralgia in India
Gamma Knife stereotactic radiosurgery is one of the latest advances in medical science & which is available at select centers around the world. Moreover, it is quite expensive treatment procedure, especially within the developed Western countries. However, trigeminal neuralgia treatment cost in India is reasonable & much lower in comparison to availability of similar treatments in other parts of the world. It is therefore a sensible idea for overseas patients to undergo treatment for trigeminal neuralgia in India, whereby they can save substantial amounts of money even after having to pay for travel, accommodation, treatments & a local exotic vacation.
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