Treatment for Facial Pain
The Facial Pain Center at New York Methodist Hospital offers a variety of treatments for those suffering from chronic facial pain.
Trigeminal neuralgia, a specific type of facial pain, is largely the result of a disturbance of the trigeminal nerve, which is responsible for carrying sensory information from the face to the brain. Pressure on this nerve by an artery or vein at the point at which the nerve enters the brain can cause it to misfire, resulting in painful sensations in the face.
This pain can also be caused by multiple sclerosis, a stroke or pressure caused by a tumor. Because the trigeminal nerve splits into three branches as it leaves the brain, pain may be felt only in the upper, mid or lower portions of one side of the face, or in several parts of the face.
Diagnosis of trigeminal neuralgia consists of excluding other possible causes, such as a dental problem, recent facial trauma, multiple sclerosis, cranial tumor or even an aneurysm.
A neurologist will likely complete a brief neurological examination focusing on muscle movement and feeling in the face. A magnetic resonance imaging or computerized tomography scan allows the doctor to check for tumors or blood vessel abnormalities as a possible cause of the pain.
Medications that lessen or block pain signals to the brain are the typical initial treatment for facial pain. Several anticonvulsant and muscle relaxant drugs are available for this use. Patients who are first seen by a neurosurgeon can also be referred to a neurologist for drug treatment.
At New York Methodist Hospital surgical options include a variety of procedures designed to prevent pain signals from being sent to the brain. Depending on the location of the pain, alcohol injections under the skin of the face can numb the afflicted area for weeks or months. Glycerol injections, the use of electric currents and balloon compression are all different surgical techniques with the same goal: to damage the trigeminal nerve, thereby blocking pain signals.
Another surgical procedure, microvascular decompression, involves moving blood vessels in contact with the trigeminal nerve without damaging it, providing the most effective and longest lasting treatment.
Two newer treatments, motor cortex stimulation and deep-brain stimulation, rely on the implantation of electrodes in various parts of the brain. Small electrical charges are then fine tuned by a neurologist and neurosurgeon to manipulate faulty neural circuits, thereby reducing the pain.
For more information, call 718.246.8614.