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Treatment alleviates nerve pain in face

February 3, 2011 12:00:00 AM PST
It's a pain that can be triggered by something as simple as a cool breeze or a bite of food. One in 15,000 people have trigeminal neuralgia, a disease that's misdiagnosed as everything from dental pain to migraines. Now highly targeted surgical treatments are helping these patients when no medicine can.

For Claire Bush, a single brush of makeup used to be enough to send a searing jolt of pain into the right side of her face.

"It burns like fire," said Bush. "It's like electricity at the same time. Just too scary. You didn't want to set it off."

For 15 years, the slightest touch set it off.

Things like applying makeup, chewing and swallowing could trigger excruciating pain. no medication helped.

"I went to a support group because I was going to kill myself," said Bush.

Trigeminal neuralgia is a disorder of the nerve that supplies sensation to the face.

Neurology Dr. Andrew Shetter offered an answer that changed Bush's life: a 30-minute treatment that focuses X-ray beams on the nerve, literally injuring it to stop the pain.

"The long-term results with the Gamma Knife are that about 50 percent of the patients will become pain-free, off medicines long-term. That's with 5- and 10-year follow-ups," said Shetter, chairman of the Division of Functional and Stereotactic Neurosurgery at Barrow Neurological Institute.

Pain can also be caused by compression of the nerve itself. In a second, less-invasive procedure called microvascular decompression (MVD), Shetter was able to move a blood vessel that was putting painful pressure on the nerve.

"That's the optimal result: no pain," said Shetter.

Now Bush is virtually pain-free and doing things she was afraid to do before. After 15 years of misery, she finally feels like herself again.

"Oh, I'm functioning again. I have my life back," said Bush.

Many patients with trigeminal neuralgia can be helped with medication. But if medication is ineffective, surgery can be a life-changing event.

Neurologists say one of the advantages of surgery is a lower likelihood of facial numbness.

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