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Facial pain can significantly affect your life. Our specialists offer the latest treatment options for trigeminal neuralgia. We tailor your care plan to your specific needs, symptoms, and source of pain. Your personalized plan may include multiple therapies to provide the greatest relief.
What We Offer for Trigeminal Neuralgia
Specialized expertise: Our program includes internationally recognized, board-certified neurosurgeons, pain specialists, and sinus surgeons who understand facial pain and how to effectively treat it.
Groundbreaking treatments: Stanford Medicine doctors lead the way in developing therapies that reduce severe pain and enhance quality of life.
A collaborative team: We have an experienced team of dedicated trigeminal neuralgia specialists who work together to provide compassionate care that prioritizes your needs.
Clinical trials: Our active research efforts provide eligible patients with early access to promising therapies available only at Stanford Health Care.
Ease of access: You can find providers, treatment, and support services at convenient locations across the Bay Area. We make it simple to get the care you need—anywhere and anytime.
Connect to Care
Let us help find personalized care options for you and your family.
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Our specialists offer a full range of nonsurgical and surgical treatment options for trigeminal neuralgia. Medications are the first-line treatment for trigeminal neuralgia, often providing effective pain relief. But for many people, medications lose their effectiveness over time. As the condition progresses, you may require surgical treatment.
Antiseizure medications that slow electrical nerve impulses are often effective for controlling pain associated with trigeminal neuralgia. Even though antiseizure (also called anticonvulsant) medications were not developed to treat pain, they provide pain relief by reducing the trigeminal nerve’s ability to send pain signals.
Your doctor may also recommend other medications, such as muscle relaxants, antidepressants, or newer drugs in development. Some people find that Botox injections also help with pain.
Neuromodulation therapies target the brain and nervous system with electrical stimulation to help relieve pain caused by trigeminal neuralgia.
Motor cortex stimulation
In this procedure, we place electrodes on the brain’s surface to disrupt pain signals. Stanford Health Care is one of the few institutions in the nation offering this procedure for trigeminal neuralgia. Our surgeons are not only experts in placing implants, but also in reprogramming implants for patients who had initial pain relief that did not last.
Trigeminal nerve stimulation
This procedure stimulates the trigeminal nerve directly to relieve pain.
Our surgeons perform the most advanced, minimally invasive surgical procedures to treat trigeminal neuralgia. Some of these procedures are available only from Stanford Health Care; others are available at only a few select hospitals worldwide. Surgical options include:
Rhizotomy is a minimally invasive procedure to treat nerve pain. Doctors use rhizotomy to interrupt pain signals by damaging the nerve.
The procedure requires access to the trigeminal nerve. Your doctor reaches the nerve by inserting a thin needle or tube through your cheek and into the base of your skull. They apply treatments through the needle or tube, including:
Radiofrequency thermal lesioning: Heats the nerve using an electrical current
Glycerol injection: Freezes the nerve by treating it with a chemical called glycerol
Balloon compression: Squeezes the nerve by inflating a tiny balloon
Rhizotomy procedures are less invasive than surgery and are generally very effective, though pain recurrence is more common. Many people also experience some facial numbness.
This is the most invasive treatment for trigeminal neuralgia. We use this procedure when trigeminal nerve root compression is the cause. Using a microscope and small instruments, the surgeon opens a window into the skull behind the ear. They tunnel through the brain to reach the trigeminal nerve and move the blood vessel compressing the nerve. Then they insert a cushion between the nerve and blood vessel to help relieve pressure. Microvascular decompression effectively relieves pain in a majority of patients and can offer long-term relief.
CyberKnife stereotactic radiosurgery is an advanced treatment that uses high-dose radiation beams to treat damaged nerves. CyberKnife does not cause pain and is highly precise, limiting damage to nearby healthy tissues. Stanford Medicine researchers invented CyberKnife in 1994 and we continue to offer the most experienced Stereotactic Radiosurgery Program in the world. We originally developed CyberKnife to treat tumors but have expanded its use to target nerves that are causing problems.
Some people find their trigeminal neuralgia symptoms improve with alternative treatments, such as acupuncture, chiropractic care, vitamin therapy, nutrition therapy, and biofeedback. Talk with your doctor about these and other options. Before trying any new treatment, always check with your healthcare providers to make sure it is safe and doesn’t interact with any other treatments you receive.
Trigeminal neuralgia can cause isolation, anxiety, and depression. We include neuropsychiatrists as part of our care team to help you cope with the debilitating mental health effects of this condition.