Trigeminal Neuralgia Treatment Option

Trigeminal neuralgia is a condition characterized by sudden, severe facial pain that can be life-altering. Its impact on daily activities, emotional well-being, and quality of life makes understanding and treating the condition a priority for clinicians and researchers alike. 

Fortunately, advancements in medical science have expanded the range of treatment options, offering relief to those afflicted by this challenging disorder. In this article, we will discuss these options in detail. 

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition affecting the trigeminal nerve, the fifth cranial nerve responsible for transmitting sensory information from the face to the brain. Patients experience recurrent episodes of sharp, electric shock-like pain, usually on one side of the face. 

These attacks are often triggered by seemingly innocuous activities such as chewing, talking, or even a light breeze brushing against the skin. Over time, the condition can progress, with pain episodes becoming more frequent and less predictable.

The exact cause of trigeminal neuralgia remains unclear. Still, it is often linked to irritation of the trigeminal nerve by a blood vessel or tumor, leading to the misfiring of pain signals. In some cases, the condition may result from underlying neurological disorders, such as multiple sclerosis or facial trauma. 

For example, trigeminal neuralgia can even be caused by dental procedures. Because the nerve blocks they perform are blind injections, where one of two things can happen: 

1. Needle trauma to the nerve or 
2. The anesthetics they use can be neurotoxic at high doses and high volumes. 

Both cases can lead to nerves becoming damaged! Risk factors include a family history of neurological conditions and advancing age, most commonly occurring in individuals over 50. Trigeminal neuralgia is also common in women. Early diagnosis and targeted treatments are essential to manage symptoms effectively and prevent long-term complications.

How Is Trigeminal Neuralgia Diagnosed?

Diagnosing trigeminal neuralgia requires a thorough evaluation to accurately identify the condition and rule out other potential causes of facial pain. The process typically includes a detailed patient history, physical and neurological examinations, and advanced imaging studies to confirm the presence of nerve compression or other abnormalities.

• Physical examination: The diagnostic journey often begins with a comprehensive physical examination. A healthcare provider assesses the patient’s medical history, focusing on the characteristics of the pain—its intensity, frequency, and triggers. 

Key diagnostic clues include the sudden, stabbing nature of the pain and its tendency to occur in specific regions of the face, correlating with the trigeminal nerve’s branches.

• Neurological examination: A neurological exam evaluates the function of the trigeminal nerve and other cranial nerves. Physicians may test facial sensations and perform other tests to identify abnormalities that suggest nerve involvement. 

The presence of specific triggers, such as light touch or routine activities like chewing, further supports the diagnosis of trigeminal neuralgia.

• Brain MRI: Magnetic resonance imaging (MRI) is a critical tool in diagnosing trigeminal neuralgia. It provides detailed images of the brain and surrounding structures. MRI helps detect potential causes of trigeminal nerve compression, such as blood vessels pressing on the nerve, tumors, or multiple sclerosis lesions. 

However, high-level imaging studies show that trigeminal nerve compression is very common in asymptomatic individuals, so we don’t fully understand why this condition ensues in many patients. 

Advanced techniques, like magnetic resonance angiography (MRA), may be employed to visualize blood vessel positioning and confirm vascular compression (see discussion above).

Treatment Options Used for Trigeminal Neuralgia

Effectively managing trigeminal neuralgia requires a personalized approach, considering the severity of symptoms, underlying causes, and the patient’s overall health. Treatment options range from medications and nerve blockers to advanced surgical techniques, each offering varying degrees of relief. 

Medications

Medications are often the first line of treatment for trigeminal neuralgia, aiming to control pain by stabilizing nerve activity.

• Anticonvulsants: Drugs like carbamazepine and oxcarbazepine are commonly prescribed and are highly effective in reducing the frequency and intensity of nerve misfiring. However, they can cause side effects such as dizziness, drowsiness, and liver toxicity, necessitating careful monitoring.
• Muscle relaxants: Baclofen is sometimes used with anticonvulsants to improve pain control.
• Other medications: Tricyclic antidepressants may be used for patients with coexisting neuropathic pain, though their effectiveness is more limited.

Nerve Blockers

Nerve blockers involve the injection of anesthetic agents, often combined with steroids, to interrupt pain signals along the trigeminal nerve. This minimally invasive procedure provides temporary relief, usually lasting weeks to months, and is ideal for patients who cannot tolerate systemic medications. 

While generally safe, nerve blocks carry minor risks, including infection, bleeding, and nerve damage in rare cases.

Surgery

Surgical options offer long-term solutions for patients whose symptoms are resistant to medications or nerve blockers.

• Microvascular decompression (MVD): This procedure involves relocating or cushioning blood vessels compressing the trigeminal nerve. MVD boasts high success rates (70–90% long-term pain relief) but carries risks such as infection, stroke, and hearing loss.
• Gamma knife radiosurgery: This non-invasive option uses focused radiation to disrupt pain signals in the trigeminal nerve. While success rates are slightly lower than MVD, it presents fewer immediate risks and a quicker recovery.
• Percutaneous procedures: Techniques such as balloon compression or glycerol rhizotomy involve disrupting nerve fibers to reduce pain. These procedures are less invasive but may lead to temporary facial numbness.

Is There an Alternative to Surgery for Trigeminal Neuralgia?

While surgical interventions can offer long-term relief for trigeminal neuralgia, they are not without drawbacks. Risks such as infection, nerve damage, and complications like stroke make surgery a less appealing option for many patients. 

Additionally, recovery can be prolonged, and certain procedures, like microvascular decompression, may not be suitable for older individuals or those with underlying health conditions.

Image-Guided Neurobiologic Injection (IGNIte) using platelet-rich plasma (PRP) offers a cutting-edge alternative. IGNIte is an advanced, precision-based procedure that utilizes real-time imaging to deliver PRP exactly where it is needed—in this case, near the affected trigeminal nerve for patients seeking effective relief without the risks and downtime of surgery. 

This minimally invasive, highly targeted approach harnesses the body’s natural healing processes to provide lasting pain relief, making it an ideal choice for individuals with trigeminal neuralgia who wish to avoid surgical intervention.

IGNIte Procedure

Platelet-rich plasma injections involve isolating growth-factor-rich plasma from the patient’s blood and injecting it with image guidance near the affected branches of the trigeminal nerve. PRP stimulates tissue repair, nerve regeneration (re-myelination), and reduces inflammation, addressing the underlying irritation contributing to nerve pain. 

Benefits of IGNIte:

• Image-Guided Precision: Ensures PRP reaches the exact location of nerve irritation, maximizing relief.

• Non-invasive: Unlike surgery, IGNIte requires no incisions or anesthesia, minimizing recovery time.
• Low risk: Because the treatment uses the patient’s blood, the risk of adverse reactions is significantly reduced.
• Pain reduction: Clinical studies suggest PRP can alleviate pain and improve nerve function, offering lasting relief (1-9).
• Repeatable: The procedure can be safely repeated if symptoms recur, providing ongoing management of trigeminal neuralgia.

How This Type of Treatment Delivers Results

PRP injections are grounded on the principle of stimulating the body’s natural healing processes to repair damaged tissue and reduce inflammation. With the IGNite procedure, PRP is delivered with unparalleled precision using advanced imaging, ensuring that the platelet-rich plasma reaches the exact location of nerve dysfunction. 

Below, we explore how this innovative treatment works and its key advantages.

Natural Healing Process

The effectiveness of PRP injections lies in their ability to enhance the body’s innate repair mechanisms. Platelets are rich in growth factors aiding tissue regeneration, reducing nerve irritation, and calming inflammatory processes. By injecting concentrated platelets near the trigeminal nerve, PRP promotes cellular repair and restores proper nerve function, addressing the root cause of pain rather than merely masking the symptoms.

With the help of our state-of-the-art processing laboratory, we can produce a high-quality platelet lysate, which is more advanced than your standard PRP. See more in the video below: 

This is critical to utilize platelet lysate when injecting around these sensitive areas.  From a safety factor, if you happen to inject a blood vessel in this area, these vessels supply the blood to your brain, so injecting whole PRP can be devastating, leading to a clot in the artery…BUT utilization of Platelet Lysate eliminates this risk because we strip away the clotting shell of platelets, filter this out, and only inject a purified high concentration of the healing growth factors! 

Minimally Invasive, Highly Targeted Procedure

Unlike traditional PRP injections, the IGNIte procedure leverages real-time imaging to ensure precise placement. This minimally invasive outpatient procedure involves:

• Drawing an adequate amount of the patient’s blood.
• Processing it in a centrifuge to isolate the platelet-rich plasma.
• Advanced image guidance to accurately inject PRP into the affected nerve area, ensuring optimal effectiveness.

This approach eliminates the guesswork of traditional injections, leading to better outcomes and faster pain relief.

Reduced Dependency on Medications

For many trigeminal neuralgia patients, managing pain involves a heavy reliance on medications like anticonvulsants or muscle relaxants, which often come with undesirable side effects. The IGNite PRP procedure offers a natural, targeted solution that reduces the need for long-term drug use, empowering patients to reclaim their lives without the burden of chronic medication.

Lower Risk of Side Effects

With any interventional procedure, there are inherent risks such as bleeding, infection, or nerve damage from needle trauma when placing a needle to target deep structures within the body. We utilize the smallest gauge needle to minimize the possibility of needle trauma. 

Another risk is an adverse reaction to what is being injected, but because PRP is derived from the patient’s own blood, the risk of allergic reactions or adverse effects is minimal. When combined with precise image-guided delivery, the likelihood of complications is even further reduced compared to surgical interventions or systemic medications. 

Promotes Long-Term Relief

Unlike temporary solutions like nerve blocks, PRP addresses the underlying causes of trigeminal neuralgia by promoting sustained tissue repair and reducing inflammation. While results may take a few weeks to manifest fully, many patients report significant and lasting relief, making PRP an investment in long-term health and well-being.

Complementary to Other Therapies

IGNIte can be seamlessly integrated into a broader treatment plan. It complements other non-surgical options, such as physical therapy or nerve blocks, and can even serve as a bridge to surgery for patients seeking to delay or avoid invasive procedures.

Common Conditions Treated by PRP Injections

When administered through the IGNIte procedure, platelet-rich plasma injections treat nerve pain and damage conditions. While PRP is widely used in orthopedic and dermatological treatments, its precise application with image guidance makes it an ideal option for managing trigeminal neuralgia and other facial pain disorders.

Facial Pain

IGNIte procedure addresses facial pain associated with trigeminal neuralgia by:

• Reducing inflammation in and around the trigeminal nerve.
• Promoting cellular repair and regeneration of affected tissues.
• Decreasing nerve hypersensitivity, which leads to fewer pain episodes.
• Enhancing blood flow to the treatment area supports long-term nerve health.

Facial pain linked to trigeminal neuralgia can be debilitating, often characterized by sudden, electric shock-like sensations triggered by everyday activities. PRP offers a minimally invasive option to manage this condition, providing relief by targeting the underlying nerve dysfunction rather than masking the symptoms.

Nerve Damage

The IGNIte procedure supports nerve repair by:

• Delivering growth factors that stimulate the regeneration of nerve fibers (axons).
• Enhancing the repair of myelin sheaths, which protect and insulate nerves.
• Encouraging the formation of new blood vessels to support healing tissues.
• Reducing chronic inflammation that impairs nerve recovery.

Manage Facial Pain with Proven Care

Trigeminal neuralgia requires care that is as precise as it is compassionate. At CSC, we combine cutting-edge treatments like PRP therapy with personalized patient care to ensure optimal outcomes. Our non-surgical approach allows patients to achieve significant pain relief while avoiding the risks and recovery times associated with traditional surgical interventions.

We invite you to explore how PRP can transform your treatment experience, offering relief and hope for a pain-free future. With CSC by your side, managing trigeminal neuralgia is no longer just about coping with symptoms—it’s about reclaiming your quality of life.

Trigeminal neuralgia is a challenging condition, but advancements in non-surgical therapies like PRP offer a new pathway to effective management. At CSC, we are committed to delivering innovative, patient-centered care that addresses the symptoms and the root causes of facial pain. If you’re looking for an alternative to surgery with proven results, our PRP treatments provide a safe, minimally invasive option tailored to your needs.

Contact us today to learn how we can help you take the first step toward lasting relief.

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Bibliography:

1. Wang, S., Liu, Z., Wang, J., Cheng, L., Hu, J., & Tang, J. (2024). Platelet-rich plasma (PRP) in nerve repair. Regenerative therapy, 27, 244–250. https://doi.org/10.1016/j.reth.2024.03.017

2. Hashim N. A., Fathy H. A., Esawy M. M., Shabana M. A. (2020). Comparison of Efficiency between Platelet Rich Plasma and Corticosteroid Injection Therapies in Patients with Carpal Tunnel Syndrome: a Prospective Randomized Controlled Study. Egypt. J. Neurol. Psychiatry Neurosurg. 56 (1), 59–67. 10.1186/s41983-020-00184-1
   https://link.springer.com/article/10.1186/s41983-020-00184-1 

3. Shen Y. P., Li T. Y., Chou Y. C., Ho T. Y., Ke M. J., Chen L. C., et al. (2019). Comparison of Perineural Platelet-Rich Plasma and Dextrose Injections for Moderate Carpal Tunnel Syndrome: A Prospective Randomized, Single-Blind, Head-To-Head Comparative Trial. J. Tissue Eng. Regen. Med. 13 (11), 2009–2017. 10.1002/term.2950.
   https://pubmed.ncbi.nlm.nih.gov/31368191/ 

4. Raeissadat S. A., Karimzadeh A., Hashemi M., Bagherzadeh L. (2018). Safety and Efficacy of Platelet-Rich Plasma in Treatment of Carpal Tunnel Syndrome; a Randomized Controlled Trial. BMC Musculoskelet. Disord. 19 (1), 49. 10.1186/s12891-018-1963-4. https://pubmed.ncbi.nlm.nih.gov/29433485/ 

5. Wu Y. T., Ho T. Y., Chou Y. C., Ke M. J., Li T. Y., Huang G. S., et al. (2017). Six-month Efficacy of Platelet-Rich Plasma for Carpal Tunnel Syndrome: A Prospective Randomized, Single-Blind Controlled Trial. Sci. Rep. 7 (1), 94. 10.1038/s41598-017-00224-6 https://pmc.ncbi.nlm.nih.gov/articles/PMC5427966/ 

6. Eltabl M. A., Saif D. S., Alemam S. E. (2020). Platelet-rich Plasma Injection versus Surgical and Medical Treatment of Mild-Moderate Carpal Tunnel Syndrome. Egypt. J. Neurol. Psychiatry Neurosurg. 56 (1), 88–96. 10.1186/s41983-020-00186-z https://link.springer.com/article/10.1186/s41983-020-00186-z 

7. Malahias M. A., Nikolaou V. S., Johnson E. O., Kaseta M. K., Kazas S. T., Babis G. C. (2018). Platelet-rich Plasma Ultrasound-Guided Injection in the Treatment of Carpal Tunnel Syndrome: A Placebo-Controlled Clinical Study. J. Tissue Eng. Regen. Med. 12 (3), e1480–e1488. 10.1002/term.2566
   https://pubmed.ncbi.nlm.nih.gov/28873284/ 

8. Chen S. R., Shen Y. P., Ho T. Y., Li T. Y., Su Y. C., Chou Y. C., et al. (2021). One-Year Efficacy of Platelet-Rich Plasma for Moderate-To-Severe Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial. Arch. Phys. Med. Rehabil. 102 (5), 951–958. 10.1016/j.apmr.2020.12.025
   https://pubmed.ncbi.nlm.nih.gov/33548206/ 

9. Senna M. K., Shaat R. M., Ali A. A. A. (2019). Platelet-rich Plasma in Treatment of Patients with Idiopathic Carpal Tunnel Syndrome. Clin. Rheumatol. 38 (12), 3643–3654. 10.1007/s10067-019-04719-7
   https://pubmed.ncbi.nlm.nih.gov/31420812/