Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain condition caused by dysfunction of the major nerve trigeminal nerve, which carries sensation from your face to your brain. There are numerous causes of trigeminal neuralgia, the most common of which is a blood vessel compressing the trigeminal nerve as it leaves the brain. Trigeminal neuralgia is treated with microvascular decompression (MVD) using a minimally invasive keyhole approach to separate the trigeminal nerve from impinging blood vessels.

In trigeminal neuralgia is caused by the disruption of the trigeminal nerve’s function. Trigeminal neuralgia can also occur as a result of aging. It can also be related to multiple sclerosis or rarely by a tumor compressing the trigeminal nerve.

Trigeminal neuralgia symptoms may include one or more of the following:

• Occasional twinges with mild pain
• Severe shooting or jabbing pain that may feel like an electric shock
• Spontaneous attacks of pain or attacks triggered by touching the face, chewing, or speaking
• Irregular painful attacks lasting days, becoming more frequent and intense over time
• Pain in areas supplied by the trigeminal nerve: cheek, jaw, teeth, gums, lips
• Pain affecting one side of your face at a time

Your Orange County neurosurgeon Dr. Louis will carefully review your medical history and perform a neurological exam. An MRI scan may be ordered to rule out other conditions such as a brain tumor, aneurysm, or AVM that may be causing facial nerve compression.

Magnetic resonance imaging (MRI): MRI scan of your head to determine if multiple sclerosis or a tumor is causing trigeminal neuralgia. Sometimes a dye may be injected Robert Louis, MD into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiogram).

Electromyogram (EMG): An EMG is often done along with a nerve conduction velocity (NCV) study to measure your muscle and nerve electrical activity.

There are no oral medications that can effectively cure trigeminal neuralgia. The only options are interventional when the symptoms progress to the point of being unbearable to the patient. A minimally invasive keyhole approach for microvascular decompression (MVD) will allow your Orange County neurosurgeon Robert Louis, MD to move or separate the blood vessel and hold it away from the irritated nerve. MVD is performed using an endoscopic retromastoid approach to create a small quarter-sized bony opening behind the ear.

Minimally Invasive Keyhole Approach

Robert Louis, MD performs this operation is performed through a quarter-sized bony opening using endoscopic techniques. This keyhole approach preserves the surrounding normal structures as best as possible. Depending on the nerve affected, various other therapies may be indicated. By incorporating cutting-edge technology and instrumentation with proven surgical experience, we make surgery safer, less invasive, and more effective. Learn more about cranial nerve disorders.

Robert Louis, MD specializes in minimally invasive removal of trigeminal neuralgia. Less invasive keyhole surgical approaches incorporate Dr. Louis’ experience and education with cutting-edge technology and instrumentation.

Retomastoid Approach 

Facial nerves and blood vessels may be approached directly using the Retromastoid Approach. Robert Louis, MD specializes in this state-of-the-art, minimally invasive keyhole approach in accessing cranial nerves and blood vessels through a small bony opening behind the ear. This approach incorporates cutting-edge technology and instrumentation with Dr. Louis’s surgical experience and training, making surgery safer, less invasive, and more effective. Read more about Retromastoid Approach.