Back to home September 2013
The Children's Hospital of Southwest Florida
Severe Facial Pain May Require Surgery
“ Many times, medication and less-invasive treatments are effective in relieving the pain,” Dr. Lin says. “Surgery is the last resort”.Facial pain is usually caused by dental or other easily identified problems—the result of an accident or trauma, a fall or something else that offers an explanation. For patients who find no relief, an appointment with a neurosurgeon might reveal a hidden cause—trigeminal neuralgia.
The condition is caused when an artery begins to touch and compress the trigeminal nerve that is located in the brain stem. "This is a very painful condition, which can be incapacitating," says Lee Memorial Health System neurosurgeon Dean Lin, M.D. "Before treatments were available, it was known as the 'suicide disease' because patients would frequently commit suicide rather than live with the pain."
In fact, by the time many patients connect with a neurosurgeon, they have already taken drastic measures to relieve the pain. "The typical time from beginning of the pain until a proper diagnosis is about nine months, and people are miserable with pain during that time," Dr. Lin says. "A lot of people have the teeth on that side of their face pulled out, thinking there is a dental problem. Most people are missing several teeth by the time I see them."
Treatment begins with medication, which is successful in many cases. Patients who need a more comprehensive approach may require treatment that involves the insertion of a needle into the nerve and either injecting it with alcohol or burning it. Only the most severe cases require surgery, where the surgeon separates the nerve from the blood vessel that had contact. Another treatment option is stereotactic radiosurgery, where the physician focuses high-powered X-rays on the affected area.
"Many times, medication and less-invasive treatments are effective in relieving the pain," Dr. Lin says. "Surgery is the last resort."
People who begin feeling unexpected facial pain should explore all potential causes with their dentist and physician before making any decisions on their care, Dr. Lin says. "A lot of people have facial pain and the No. 1 reason is a dental problem," he says. "Very few people have true trigeminal neuralgia."
Neurosurgery: Trigeminal Neuralgia (Face Pain)
Dean Lin, M.D.
Lee Physician Group
2780 Cleveland Avenue
Fort Myers, FL 33901