Trigeminal Neuralgia

It has been described as frequent stabs of lightning-like pain that shoots through one side of the face. In some cases, the attacks are spontaneous, while in other instances, they can be triggered by simple activities of daily living. Trigeminal Neuralgia has been called one of the most painful conditions a person can experience.

Nebraska Medicine's physicians can provide you with a full range of treatments for trigeminal neuralgia including medications, surgery and radiation treatment (radio surgery) that can ease or eliminate your pain.

We Strive to Unearth the Root Cause

While there is no specific test for trigeminal neuralgia, our doctors will conduct a thorough medical exam and perform several tests that can be useful to help identify the cause of your pain including a CAT scan or MRI. One of the most common causes of this condition involves a blood vessel pressing on the trigeminal nerve as it exits the brain. An MRI may be able to reveal the presence and severity of nerve compression or can help rule out other causes such as a tumor or multiple sclerosis.

We Offer a Variety of Ways to Break Free of Trigeminal Neuralgia Pain

There are a number of treatments available to treat trigeminal neuralgia. Depending on the severity and frequency of your pain, your age and general health condition, we can help you determine which treatment option is best for you including:


Most people who require medical treatment for trigeminal neuralgia begin with medications. Several types of medications are needed for adequate pain relief and no single medication works best for all people. Our highly skilled physicians will prescribe the most current and effective medications available and will find the right combination for you to relieve your pain.

Surgical Options

If medications do not provide adequate pain relief, or if they cause bothersome side effects, surgery may be appropriate. Because we are a leader in neurology and neurosurgery our neurosurgeons can offer you the most advanced surgical options including:

Microvascular Decompression Surgery

This procedure is the only one that gets to the presumed cause of trigeminal neuralgia in most people -- pressure exerted on the trigeminal nerve by a blood vessel. This surgery has the potential benefit of relieving pain without causing numbness in the face, and it may have better long-term success compared to other surgical treatments.

Percutaneous Procedures

These procedures have, in general terms, a 60 percent rate of providing long-term relief. In many cases, if pain recurs, these procedures can repeated. There are three types of percutaneous procedures and each involves inserting a needle through the cheek into or next to the nerve as it passes through the base of the skull. The three techniques vary according to how the nerve is treated once the needle is in position. These procedures are usually performed on an outpatient basis.

Sterotactic Radiosurgery

Stereotactic radiosurgery is a relatively newer, minimally invasive procedure that is becoming a popular treatment option for trigeminal neuralgia. Nebraska Medicine uses the precision of its Novalis single-radiation technology to deliver a very precise dose of radiation to the trigeminal nerve where it exits the brain to reduce pain signals in the trigeminal nerve. This approach has the advantage of avoiding open surgery, is painless and performed without anesthesia and has a lower risk of facial numbness compared to percutaneous techniques.