Trigeminal Neuralgia

Our medical and surgical doctors in Key West collaborate with an aim to enhance quality of life for individuals suffering from chronic facial pain, including trigeminal neuralgia. At Neuro Spine & Pain Center, our pain specialists create a treatment plan tailored to patient’s specific needs. With accurate diagnosis and innovative solutions like restorative surgical procedures, we strive to bring transformative results. Experience the difference for yourself.

What is trigeminal neuralgia?

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve (responsible for transmitting sensory information from the face to the brain). It occurs as a result of nerve compression by a blood vessel. Also referred to as ‘Tic Douloureux’, the condition is characterized by sudden, severe facial pain that can be triggered by even mild movements such as brushing teeth, smiling, putting on makeup or touching the face. The pain is often described as electric shock-like or stabbing and can last for seconds to minutes at a time.

What causes trigeminal neuralgia?

Trigeminal neuralgia can be caused by various factors that affect the trigeminal nerve. The most common cause is compression of the nerve by blood vessels, usually an artery, as it exits the brainstem. Another common cause is a condition that affects myelin sheath (a covering that protects certain nerves).

Other less common causes of trigeminal neuralgia may include:


Tumors in or around the trigeminal nerve can cause compression and result in trigeminal neuralgia.

Facial Trauma

Injury or trauma to the face or head, dental procedures, or even sinus infections can cause nerve damage resulting in trigeminal neuralgia.

Brain Lesion / Abnormal Blood Vessel Formation

Rarely, abnormal blood vessel formation (vascular malformations) can lead to trigeminal neuralgia.


In some cases, a stroke can cause damage to the trigeminal nerve, leading to symptoms of trigeminal neuralgia.

Surgical Injury

In some cases, surgery or dental procedures that involve the trigeminal nerve or surrounding tissues can result in nerve damage, which can lead to the development of trigeminal neuralgia.

What are the symptoms of trigeminal neuralgia?

Common Symptoms of TN may include the following listed below:

  • Pain attacks that last from a few seconds to a few minutes, and may occur several times a day.
  • A constant burning, dull ache in the face between pain attacks (less intense as compared to the spasm-like pain).
  • Shooting pain usually described as electric shock-like Pain attacks.
  • Pain that is often triggered by common activities, such as eating, talking, or touching the face, or even by cold air or wind.
  • Pain gets severe and more frequent with time.
  • Pain can be felt in the areas served by the trigeminal nerve such as cheek, jaw, teeth, gums, and lips.


The diagnosis of trigeminal neuralgia typically involves the following steps:

Initial Discussion

You will be enquired about symptoms followed by a medical history review.

Physical Exam

The doctor will typically test the affected area of the face to determine the location and severity of the pain. They may also check for any other neurological symptoms (weakness or numbness in the face) to assess an underlying condition.

Trigeminal Reflex Test

The neurological exam evaluates the function of the trigeminal nerve, the main sensory nerve of the face. The test is performed by tapping the facial area with a small hammer or rubber mallet and observing the patient's response.

Other Tests

Doctors may suggest imaging tests, such as an MRI or CT scan for taking pictures of the head and structures surrounding the area. It is helpful in identifying any abnormalities in the trigeminal nerve or surrounding tissues.

Treatments for Trigeminal Neuralgia

Standard Treatment for Trigeminal Neuralgia

The standard treatment for trigeminal neuralgia typically involves a combination of antiseizure medicine and lifestyle modifications. The goal of treatment is to reduce the frequency and severity of pain episodes and improve quality of life.


For individuals who do not respond to medication or have severe symptoms, surgical intervention may be considered. It helps reduce pressure on trigeminal nerve or nerve blocks.

Microvascular Decompression for Trigeminal Neuralgia

This surgical procedure involves identifying and separating the trigeminal nerve from the blood vessels that may be compressing it and causing pain. A tiny cushion is placed to create a barrier between the two. Since it is a curative procedure, patients can feel immediate pain relief.

Percutaneous Rhizotomy and Radiosurgery

These are two additional minimally invasive, outpatient surgical options that may be used to treat trigeminal neuralgia.

1. Rhizotomy - This minimally invasive surgical procedure involves using a needle to access the trigeminal nerve through the cheek. The surgeon then applies heat (radiofrequency) or a chemical agent (glycerol) or a balloon to damage the part of the nerve that is causing pain. This procedure is often performed under local anesthesia, and patients can usually go home the same day.

2. Stereotactic Radiosurgery – This non-invasive procedure uses super-focused radiation to damage the trigeminal nerve and reduce pain. Radiosurgery may be a good option for individuals who are not good candidates for surgery due to age, medical conditions, or other factors. However, it may take several weeks or months for the full effects of the treatment to be realized.

Why Choose Our Neuro Spine & Pain Center for Trigeminal Neuralgia Treatments?

At Our Neuro Spine & Pain Center, you will be guided by a skilled surgeon who is experienced in using different types of surgical treatments for trigeminal neuralgia. These treatments include rhizotomy, stereotactic radiosurgery, and microvascular decompression.

Personalized Care for You

We understand how trigeminal neuralgia can impact your daily life and goals. Our team takes the time to get to know you and your unique needs. With this information, we work together to find the most effective treatment plan for you.

Experienced Professionals

Our team of experts has helped many patients dealing with trigeminal neuralgia. We offer a variety of safe and effective techniques that can be tailored to fit your lifestyle and treatment goals.

Safe and Convenient Appointments

In response to the COVID-19 pandemic, we have implemented special safety measures to ensure that we can provide timely and secure care. This includes offering virtual consultations so that you can receive treatment without having to travel.

Best Spine Surgeons and Pain Specialists

Dr. William Schnapp

Board-certified Neurologist

Dr. Jon Gottlieb

Orthopedic Spine Surgeon

Dr. Doug Hollern

Orthopedic Spine Surgeon

Jorge Lerma, ARNP


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