Trigeminal neuralgia is a chronic disease that is manifested by short-term episodes of severe pain in the face. Patients suffer not only from the pain syndrome, but also from the constant fear of a new attack, as they live in anticipation of it. However, the patient can get rid of this disease once and for all. The treatment of trigeminal neuralgia in Germany involves the use of minimally invasive procedures, neurosurgery, and radiosurgery. For the first time in the world, successful surgical treatment of trigeminal neuralgia was performed in Germany, in 1853, by Carl Edler von Patruban. More than a century and a half later, Germany remains one of the countries that achieved the best results in the treatment of this disease.
Content
- Symptoms
- Treatment
Trigeminal neuralgia is treated with drug therapy. If it does not work, the doctors carry out minimally invasive procedures, neurosurgical operations, or resort to a radiosurgical method.
You can undergo treatment at the University Hospital Rechts der Isar Munich, the Charite University Hospital Berlin, the University Hospital Freiburg.
You can contact the Booking Health specialists. We will select the best clinic for you and fully organize your trip.
Symptoms
Trigeminal neuralgia causes severe pain in the face, reducing the quality of life of patients. About 1 million people suffer from this disease worldwide. The right side of the face is most commonly affected. The main category of patients are women over 50 years.
In many cases, the trigeminal nerve roots are closely adjacent to the vessels, which creates conditions for the trigeminal nerve compression that is considered the cause of the development of the disease. The person has periodic attacks of pain. They last about 2 minutes and can be repeated up to 200 times a day. The person feels healthy between attacks.
Treatment
Conservative therapy is effective in 80% of patients. Drugs can relieve pain and reduce the frequency of attacks. However, it is possible to reduce the effectiveness of treatment in the future, so you have to resort to minimally invasive procedures and operations.
Treatment options:
Alcohol block is the simplest procedure. Ethyl alcohol at a dose of 1,5-2 ml is injected into the bone canal. The result is a temporary effect that lasts for 6-12 months. When the pain returns, the procedure can be repeated.
Percutaneous radiofrequency destruction is the destruction of the trigeminal nerve root due to heating. This procedure provides longer-term results that can last for several years. However, the procedure causes facial numbness in every third patient. The effectiveness of the procedure is about 75%.
Glycerol rhizotomy is the destruction of the trigeminal ganglion through the oval hole with pure glycerin. The effectiveness of the procedure reaches 90%, and in 60% of patients, the effect occurs immediately. About 75% of people no longer need drug therapy. In 85% of patients, the effect persists for more than 7 years. However, the procedure gives side effects, the most common of which are the weakness of the masticatory muscles – 13%, hypersensitivity in the face – 30%, and a decrease in the corneal reflex – 41,5%.
Percutaneous balloon compression – doctors puncture the foramen ovale and insert a Fogarty balloon catheter into the trigeminal cistern. Then it is inflated, which leads to mechanical damage to the trigeminal ganglion. The procedure is effective in most patients. The risk of pain recurrence within 10 years is 31%. The probability of developing hypersensitivity in the face is 15%.
Microvascular decompression of the trigeminal nerve root is the main treatment method. The doctor performs a trepanation of the posterior cranial fossa and finds an area of compression of the nerve root by the vessels. They are isolated, and a special pad is placed between the vessels and the root, preventing contact between them. The efficiency of this operation is high: at least 66%, and in specialized centers in Germany, it reaches 92%. Patient mortality is on average 0,5%, and in German hospitals, it is close to zero.
Gasser's ganglion radiosurgery is the destruction by irradiation. It is a non-invasive treatment method that was first used in 1971. Since then, radiosurgery has become more precise, so complications rarely develop. However, there is still a risk of damage to the cranial nerves (about 10%).
To undergo diagnostics, treatment of trigeminal neuralgia in Germany, and neurological rehabilitation, you are welcome to use the Booking Health service. On our website, you can find out the cost of medical services. Compare how much is the price of treatment in different clinics in Germany in order to book a medical care program at favorable prices. The Booking Health specialists will help you choose a clinic and organize your trip.
Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Journal of Neurology, Neurosurgery and Psychiatry
World Federation of Neurology
MedlinePlus
