Trigeminal Neuralgia: Therapy

General measures

  • Avoidance of long stays in the cold
  • Avoidance of environmental pollution:
    • Heavy metal intoxications

Conventional non-surgical therapy methods

  • Radiofrequency thermocoagulation – Pain fibers in the Gasserian ganglion are thermally eliminated (70-75 °C for 90 s) by a radiofrequency probe inserted through a horizontal cannula.The Gasserian ganglion is the ganglion (nerve node) where the fifth cranial nerve (trigeminal nerve) divides into its three main branches.
  • Glycerol rhizolysis – via a horizontal cannula, 0.3-0.4 ml of anhydrous glycerol is injected into the cavum meckeli (cavum trigeminale) to eliminate the pain fibers.
  • Radiosurgery – one-time irradiation of the nerve root entry zone with Gamma-Knife or CyberKnife; indication: secondary trigeminal neuralgia, in case of recurrence (recurrence of the disease) and/or in case of contraindications (contraindications) for MVD (see below “Surgical therapy“).

Operative therapy

  • Microvascular decompression (MVD) [surgical gold standard]The operation: it is a cause-rectifying neurosurgical treatment method: trepanation (opening of the skull), identification of the pathological vascular-nerve contacts: most often it is a compression caused by the superior cerebellar artery (about 80% of cases; less frequently, the inferior anterior cerebellar artery or a dilated basilar artery). Subsequently, elimination of vascular-nerve contacts by interposition (insertion) of a cushion (muscle tissue or small sponges made of Teflon). Effect: MVD has a very good success rate – even in the long-term course.

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.