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New treatment to cure trigeminal neuralgia

July 22, 2011 12:00:00 AM PDT
Imagine pain striking your face so severely it stops you from eating, talking, or even moving. It's called trigeminal neuralgia and it happens to almost 2 million people each year in the U.S. Now, there's a surgery that can eliminate the pain and get these people back to living normal lives.

Merelia spent years trying to figure out what was happening to her. Sharp pains stabbed her face until finally she was diagnosed with trigeminal neuralgia.

"It's like ripping your eye or stabbing it," said Merelia.

Trigeminal neuralgia is basically a short circuit in the trigeminal nerve, according to Dr. Robert Goodman, chairman of the Department of Neurosurgery at St. Luke's-Roosevelt Hospital.

One-hundred-forty-thousand nerve fibers make up the trigeminal nerve. Most of them send normal messages to the brain, like when something touches your face, but many of those fibers only send pain messages. Each nerve is insulated, but when that insulation is damaged, the pain nerves can be activated.

"So, all the sudden, they'll send a lot of messages, a burst of messages, of course the brain will think it's something painful happening in the face," said Dr. Goodman.

That's what happened to Abe Gruenwald, who was misdiagnosed by doctors and dentists for seven years. He had three root canals, all unnecessary.

But his medical mystery ended when he found Dr. Goodman, who performed microvascular decompression surgery to cure Gruenwald's trigeminal neuralgia.

To the right of the trigeminal nerve is the basilar artery, which is pushing on it and causing the pain. Dr. Goodman made a small opening in the bone behind the ear and was able to move the artery and blood vessels away from the nerve. He inserted a shredded Teflon felt and sponge material that prevents it from touching the nerve -- giving it a cushion, so it can't press against it again.

"Now the nerve is where it's supposed to be. It's lying flatter, straighter. So, that really solved the problem," said Dr. Goodman.

Merelia had the surgery and woke up with no pain. And for 90 percent of other patients, it's a cure.

"I've had zero pain or episodes since then," said Gruenwald.

The first line of treatment for trigeminal neuralgia is medication. Then doctors might try radiation to target the nerve and shrink it, but Dr. Goodman says the surgery is the only way to cure it.


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