Our services | Trigeminal nerve stimulation for facial pain
Trigeminal nerve stimulation for facial pain
About trigeminal nerve stimulation
Patients with trigeminal neuralgia and atypical facial pain whose symptoms fail to respond to medical therapy may sometimes achieve effective pain relief from trigeminal nerve stimulation.
Trigeminal neuralgia is a condition affecting adults of all ages that is characterised by repeated very brief attacks of pain shooting through the cheek on one side of the face. These pain attacks tend to be triggered by touching the skin over the cheek area, by wind on the face, or by activities such as talking or chewing.
Atypical facial pain describes a group of conditions with neuralgiform pain without all the features of trigeminal neuralgia and without any alternative explanation in terms of local tissue or nerve injury.
Many patients respond to medical therapy, but others require interventional procedures such as trigeminal nerve lesioning or neurovascular decompression. Trigeminal nerve stimulation offers advantages over procedures that work by partially damaging the nerve as there is less risk of resultant permanent sensory loss over the face and is reversible simply by turning the stimulation off.
Around half the patients in our unit achieve rewarding long-lasting relief of pain after trigeminal nerve stimulation.
How does trigeminal nerve stimulation work?
Facial pain of any cause is perceived in the brain by means of electrical signals transmitted via a nerve leading into the base of the brain called the trigeminal nerve. High frequency electrical stimulation of the nerve acts to block the pain signals and is instead perceived as painless tingling over the face or sometimes is not perceived at all.
Procedures and equipment involved in trigeminal nerve stimulation
Stimulation is achieved by an electrode applied to the trigeminal nerve normally at the root entry zone just at the point where the nerve enters the base of the brain. Access to this area requires an operation under general anaesthetic via a craniotomy (bone flap) to reach the side of the brainstem.
As with other stimulator procedures, the electrode is then connected by leads tunneled under the skin to a battery control box placed under the skin at a convenient site normally in the abdomen.
Follow-up after trigeminal nerve stimulation
After surgery, patients are reviewed in the neurostimulator clinic where adjustments are made to the stimulation parameters via a remote control device that communicates with the battery control box. Patients are also given their own personal remote control devices so that they can adjust the strength and switch on and off stimulation themselves at any time.
Stimulation voltages required for trigeminal nerve stimulation are normally very low, and so batteries may last around 10 years. Replacement batteries can normally be implanted during a simple day-case local anaesthetic procedure.
