Treatment of trigeminal neuralgia

Trigeminal neuralgia manifests as sudden, excruciating facial pain, comparable to electric shocks, triggered by everyday gestures: speaking, chewing, shaving, brushing one's teeth. This pain, among the most intense there is, profoundly affects quality of life when it recurs. Treatment is based first on specific medications, which are effective in most patients. When the pain resists medical treatment or the treatment is poorly tolerated, several surgical solutions exist. The most comprehensive is microvascular decompression: in many cases, the neuralgia is caused by a small artery pulsating against the trigeminal nerve; the operation consists of placing a protective cushion between the vessel and the nerve, under the microscope, through a small opening behind the ear. Less invasive techniques (thermocoagulation, balloon compression) may also be offered depending on the patient's age, general condition and preferences. The choice of technique is discussed case by case with the neurosurgeon. At Clinique Pasteur Tunis, the management of trigeminal neuralgia combines precise assessment — high-resolution MRI looking for the conflict between vessel and nerve — and the expertise of a neurosurgical team equipped with the operating microscope and intraoperative monitoring.