In trigeminal neuralgia (severe, electric-shock-like facial pain often mistaken for toothache) and hemifacial spasm (one side of the face twitching, the eyelid closing), a blood vessel presses on a nerve where it leaves the brain.
Treatment
- Medicine such as carbamazepine is tried first
- When the maximum dose no longer controls the symptoms, MRI shows the compression
- Microvascular decompression (MVD): through a small opening behind the ear, the vessel is moved away from the nerve under the microscope and a Teflon pad is placed between them
In 90–95% of trigeminal neuralgia patients the pain goes away completely.