Trigeminal Neuralgia Treatment in Hyderabad: Medicines, MVD, and Radiosurgery
Trigeminal neuralgia (TN) causes sudden, electric shock–like facial pain in one or more branches of the trigeminal nerve. Attacks can be triggered by touch, chewing, or even wind. Most patients start with medicines. If pain persists or side effects limit dosing, procedures such as microvascular decompression (MVD), stereotactic radiosurgery, or percutaneous rhizotomy may help—chosen to fit your MRI, health, and goals.
Symptoms
- Severe, brief, stabbing facial pain, often unilateral
- Triggered by light touch, brushing teeth, shaving, or chewing
- Pain‑free intervals between attacks (typical TN); less typical variants can be more constant
Diagnosis
- Clinical history and exam
- MRI (with sequences to assess for vascular contact/compression and to rule out other causes such as multiple sclerosis)
- Dental and ENT evaluations when indicated to exclude local pathology
Stepwise treatment
1) Medicines (first line)
- Carbamazepine or oxcarbazepine are commonly used; others may include baclofen or lamotrigine in select cases.
- Monitoring: blood counts, sodium, drug interactions, and side effects per guidelines.
2) Microvascular decompression (MVD)
- For classic TN with vascular compression in medically fit patients.
- Goal: separate the offending vessel from the nerve with a cushion, aiming to treat the root cause.
- Benefits: high rates of durable pain control in suitable candidates; no nerve injury intended.
- Risks: infection, bleeding, CSF leak, hearing changes, facial weakness, stroke (rare but serious), anesthesia risks.
3) Stereotactic radiosurgery (Gamma Knife)
- Non‑incisional outpatient option that focuses radiation on the nerve root entry zone.
- Pain relief can be delayed by weeks; some develop facial numbness.
4) Percutaneous rhizotomy (radiofrequency/balloon/glycerol)
- Image‑guided procedures targeting the nerve for pain relief.
- Often used when rapid relief is needed, or when surgery/radiosurgery is unsuitable.
- Trade‑off: higher chance of facial numbness; durability varies.
Choosing the right option
- MRI findings (vascular loop vs none)
- Age, comorbidities, and anesthesia fitness
- Pain pattern, side effects from medicines, and personal preferences
We discuss the benefits, risks, and expected timelines for each route, then individualize your plan.
Recovery timelines (typical ranges)
MVD
2–4 days in hospital; gradual return to routine in 2–3 weeks if recovery is smooth.
Radiosurgery
Day‑care; pain relief may take weeks; minimal down time initially.
Percutaneous
Usually day‑care; rapid recovery; facial numbness is more common.
Costs and insurance (Hyderabad)
- Medicines are OPD costs; procedures are typically covered for indicated cases after pre‑authorization.
- Written estimates provided after evaluation and MRI review.
When to seek urgent care
- Persistent fever, severe headache, fluid from incision (after MVD)
- New neurological deficits (double vision, weakness), or uncontrolled pain
Book a Consultation
TN is highly treatable. We'll help you optimize medicines and discuss MVD, radiosurgery, or percutaneous options when appropriate. Book a consultation at Yashoda Hospitals – Malakpet and bring your MRI and medication list for a personalized plan.
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Future service pages: Microvascular Decompression, Radiosurgery (when created)
References
Disclaimer
Educational content only; decisions are individualized after evaluation and imaging. Risks and benefits vary by patient.
Last medically reviewed: October 1, 2025 — Medical reviewer: Dr Sayuj Krishnan, MBBS, DNB Neurosurgery (Direct 6 years)