Best Facial Neuralgia Treatment in India

Facial neuralgia, also known as tic douloureux or trigeminal neuralgia, describes a condition whereby an individual experiences a sharp, stabbing pain in the teeth, jaw, or gum. The nerve that is majorly affected in this condition is the trigeminal nerve which is the largest and most complex cranial nerve; it functions to provide sensation to the face and also serves to stimulate the masticatory muscles. So, when this nerve becomes neuralgic – as facial neuralgia – it means it has been irritated or damaged. The painful sensation that is triggered with facial neuralgia normally affects one side of the face but it may sometimes be felt on both sides [of the face] – though not simultaneously. Neuralgic facial pain can be triggered when the affected individual is eating, brushing, shaving, talking, kissing, or even as a gentle breeze blows over a patient’s face. This condition is most prevalent among the older population – within the age gap of 50 – 60 years – and men are more affected than women. Seeking facial neuralgia treatment may not be deemed necessary by persons who suffer this condition as the pain may last for only few seconds or even recede completely. It does not, however, rule out the fact that facial neuralgia can lead to certain debilitating consequences like depression, marked weight loss, and consequently poor quality of life.

Types of Facial Neuralgia

Facial Neuralgia is typified based on the causative factor(s), and as such there are two types – Primary Facial Neuralgia and Secondary Facial Neuralgia. Primary facial neuralgia accounts for 95% of all cases of facial neuralgia, and it is caused by pressure exerted on the trigeminal nerve proximate to the brainstem that regulates the transmission of messages between the brain and other parts of the body. The compression occurs as the artery and vein come in contact with the trigeminal nerve – though it has to be stated that it is not all such contacts that lead to facial neuralgia. Secondary facial neuralgia, on the other hand, is manifested when other (underlying) medical conditions [like facial injury, demyelinating disease, cyst, or multiple sclerosis] cause the exertion of pressure on the trigeminal nerve.

When is Facial Neuralgia Treatment Necessary?

You might have to consider going for a comprehensive facial neuralgia treatment if the painful sensation subsists – this should be at the behest of your medical practitioner and after the condition must have been diagnosed. Additionally, surgical options may be recommended in the event other (pharmacologic) facial neuralgia treatments have failed to effectively address your situation. This can also be the case if the medications a patient is using cause sustained side effects like nausea and dizziness.

Pre-treatment Considerations

As you plan to visit the clinic for facial neuralgia treatment for your consultation with a specialist, it is important that you have certain key points to be better prepared. From the very first moment, your appointment was set till the hour of consultation, you should be focused on writing down the symptoms [you have been observing] – take note of how long the pain lasted – the triggers and the medications you might have been taking. Also, consider asking the specialist vital questions bordering on the most appropriate treatment course for you, the frequency of the treatment, and the possible outcome of the selected treatment.

On his/her part, the specialist will seek to have a close examination to see where the pain is located, and also seek to know your medical history, particularly focusing on unravelling the cause of your condition and to know if you have had a facial neuralgia treatment in the past. It is on the back of this that the specialist will work out the best treatment strategy for you. 

Treatment Options for Facial Neuralgia in India

As already established, facial neuralgia can be treated through surgical and non-surgical means. Hinting on the non-surgical therapeutic intervention; a class of drugs known as anticonvulsant is usually the first port of call. These drugs act by suppressing the flow of electrical impulses in the nerves to the end of limiting their capacity to transmit pain signals. Some notable examples of such drug is carbamazepine, gabapentin, lamotrigine, clonazepam, oxcarbazepine and phenytoin. Antispasmodic agents are another set of medications that can be used – either alone or as combinatory therapy with carbamazepine – to treat facial neuralgia.

Surgical Approaches

There are a host of surgical procedures that have been used to attain favourable outcomes in the treatment of facial neuralgia. Some of these include:

• Microvascular Decompression: Microvascular decompression is an invasive surgical protocol that has to do with the excision of the blood vessels from the base of the trigeminal nerve. To carry out this procedure, the surgeon places the patient under general anaesthesia, makes a post-aural (that is, behind the ear) incision, and drills a burr hole on the skull to lift it thus gaining access to the trigeminal nerve. The surgeon now rids the impacting artery from the trigeminal nerve, and then puts a soft cushion between the artery and the nerve. Severance of the trigeminal nerve may be done if there is no contact between it and any blood vessel.
• Radiofrequency Thermal Lesion: Local anaesthesia is used to numb the patient when carrying out this procedure which is targeting at destroying the nerve fibres implicated in facial neuralgia. In this surgery, the surgeon guides, through the patient’s face, a hollow needle down to portion of the trigeminal nerve that reaches the opening at the cranial base. With the needle in place, the specialist relaxes the effect of the anaesthesia to temporarily keep the patient awake and then inserts an electrode through the needle. After this, the surgeon sends a mild electrical current down to the electrode’s tip and asks the patient to communicate when he/she feels a tingling; the patient will also be expected to indicate the spot where this feeling was impacted. Once the surgeon has a grasp of this spot, the patient is returned to sedation and the surgeon moves to destroy the nerve fibres causing facial neuralgia by heating the inserted electrode thus bringing about the creation of lesion at the surgical site. This process of heating the electrode may be repeated till the pain is completely eliminated.
• Stereotactic Radiosurgery: This is not a surgery in the traditional sense as no incision is required. For this protocol, after applying local anaesthesia to the affected area, the surgeon will fit a stereotactic frame to the patient’s head and then insert four special pins around the scalp. A few high-dose radiations are then directed to the head for about 1 – 2 hours with the head [fitted with the frame + inserted pins] held within a device. The radiation, which can be delivered through devices such as Gamma Knife, Linear Accelerator, or CyberKnife, then destroys the trigeminal nerve. Once the procedure is completed, the frame and pins are detached and the patient is allowed to take a rest immediately.
• Glycerol Rhizotomy: This also involves the insertion of a needle through the face of the patient down to the opening at the cranial base. With the aid of an imaging device, the surgeon guides the needle to the point of intersection of the nerve’s three branches – ophthalmic, maxillary, and mandibular – that make up the trigeminal nerve. A small dose of glycerol is then injected through the needle, and this acts to destroy the trigeminal nerve thereby blocking the signals causing the pain from being transmitted. Glycerol rhizotomy involves the use of local anaesthesia.
• Balloon Compression: This is another minimally invasive surgical facial neuralgia treatment. To perform this operation, the surgeon first applies local anaesthesia to numb the surgical area. Thereafter, he/she inserts a needle through the cheek of the patient, guiding it down to the trigeminal nerve that passes through the cranial base. The surgeon then positions a balloon within a touching distance of the trigeminal nerve using a catheter – which is a small flexible tube – inserted into the needle. Having completed the setup, the surgeon will move to inflate the balloon, and the pressure so generated will eventually destroy the trigeminal nerve and block off pain signals.

Cost of Doing Facial Neuralgia Treatment in India

On the issue of cost, it is somewhat difficult to have a definitive and/or straightforward answer. For one, the cost of taking pharmacologic therapy might keep accumulating as the patient attempts to suppress the pain time and again – this is where surgical procedures which may offer relief for a relatively longer period get to be cost-effective. Nevertheless, you should note that the severity of your condition, as well as other salient factors will influence the overall cost of treatment. To this end, it is ideal that you contact The Esthetic Clinics today to have our specialist give you a comprehensive cost breakdown.

Facial Neuralgia Treatment at The Esthetic Clinics

Looking for a top medical center to have your facial neuralgia treatment in India? The team of specialist plastic surgeons at The Esthetic Clinics is ready to give you top-notch service that would leave you painless again. We are fortunate to have one of India’s best cosmetic surgeon, Dr. Debraj Shome with us, and on top of this, our facilities are world class – we bring excellent facial neuralgia treatment nearby. So, you can be assured of getting nothing short of excellent quality.