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Research has shown that Gamma Knife Stereotactic Radiosurgery (GKRS) is an effective treatment for the medical condition trigeminal neuralgia. This is a common condition that is characterized by excruciating facial pain.

Gamma Knife has proven itself to be as safe and effective treatment for people who suffer from trigeminal neuralgia.  It is very popular as patients won’t have to worry about the potential facial paralysis and the long-term recovery experienced with conventional surgery.

Research studies conducted have only way to the outcome of patients who have had gamma knife radio surgery for their trigeminal neuralgia. A group of 400 patients who suffered from the condition were given 201 narrow “pencil beams” of radioactive cobalt-60 at the trigeminal nerve focusing precisely on the target and minimizing radiation effects to surrounding healthy tissues.

In the study 90% of the patients with trigeminal neuralgia had significant pain relief after around one month. Approximately one-third of these patients did experience some degree of facial numbness, but 80 percent reported a significant improvement in their quality of life since the numbness was much more tolerable than the facial pain.

Trigeminal neuralgia, also known as tic douloureaux, is a condition that is characterized by electric shock-like pain in one or more of the three trigeminal nerve distributions in the face. Common triggers of pain associated shall include brushing the teeth, eating, talking, wind and exposure to cold air.

Trigeminal neuralgia, or TN, is a medical condition that affects areas of the face where the trigeminal nerve’s branches are distributed. These areas would include the eyes, lips, scalp, nose, forehead, upper and lower jaws. The condition is often caused by an artery that causes compression to the nerve. This will result in the person feeling mind-numbing, stabbing electric shock-like pain.

This condition said to book the most severe types of pain known to humanity. The most common forms of trigeminal neuralgia affects 1 in 15,000 to 20,000, but 1 in 5,000 are thought to suffer from some type of facial pain.

This condition is often known as the suicide disease as the people are often in total agony. For some people if they touch their eyebrow it feels as if they stuck their finger in an electrical outlet. If they go outside and the wind touches their face, it will feel like the most intense toothache ever.

Despite the pain, new research has developed a new method for classifying and diagnosing TN. This method will allow the patient to do much of the diagnosis themselves. A research team has developed the world’s first online, artificial neural network to be used as a diagnostic tool for facial pain syndromes. It is an artificial intelligence-based computer program built around a classification scheme that categorizes forms of the disorder, and it can be trained to recognize patterns in facial pain data and continually improve its accuracy in predicting the correct diagnosis.

If a patient is able to have an accurate diagnosis, that means they will be able to quickly seek appropriate treatment. Sometimes a patient may state that there have been a pain and go to the dentist, from there the dentist might give them a root canal. This could continue until it is decided that the source of the pain might be something else.

The main researcher has used an 18-point questionnaire he developed that will allow him to clinically diagnose facial pain. Since facial pain types are based almost solely on a patient’s medical history, the questionnaire is comprised of yes-or-no questions that tend to make a difference in establishing the target diagnosis, such as whether the patient has multiple sclerosis, has suffered a facial injury or has had surgery for facial pain, and whether the pain is on just one side of the face or manifests during certain daily activities, like shaving or eating.

The responses they get from the questionnaire is then used to place the patient into one of seven trigeminal neuralgia categories. Type 1: or spontaneous, but severe and brief pain. Type 2: or spontaneous, more constant pain; trigeminal neuropathic pain from facial trauma, oral surgery, stroke or other causes; trigeminal deafferentation pain from procedures that intentionally injure the trigeminal nerve system to relieve other pain; symptomatic trigeminal neuralgia from multiple sclerosis; postherpetic neuralgia from trigeminal shingles; and atypical facial pain, which is more psychological rather than physiological in origin.

Burchiel doesn’t think patients should have to wait until a clinic visit to get a diagnosis, so he developed the artificial neural network, which patients can easily, and confidentially, access on the OHSU Department of Neurological Surgery’s Web site.

The computer system when used was able to accurately diagnose most of the patients who suffered from the condition. It also correctly diagnosed trigeminal neuralgia Type 1 with 84 percent sensitivity and 83 percent specificity among another 43 new patients who used the network before their clinic diagnosis. Sensitivity is a measure of a diagnostic tool’s ability to make a correct diagnosis, and specificity describes its ability to avoid a misdiagnosis.

One treatment for trigeminal neuralgia is surgery that is calledmicrovascular decompression. The procedure involves entering the brain through a small incision behind the ear. Once in there, the doctor will try to find and expose the trigeminal nerve with a powerful surgical microscope. The doctor will then position a piece of Teflon between the nerve and the artery that’s touching it and causing the pain.

Generally the procedure will offer longer-term relief from facial pain.

Oxycarbazepine  (OXYCARBAZEPINE  ), a keto-analog of carbamazepine (CARBAMAZEPINE), is as almost as effective as carbamazepine for the treatment of the condition trigeminal neuralgia. A double study conducted the shoulder it is better tolerated.

A study was conducted at the University of Michigan the in Ann Arbor, Michigan to look at the findings of Oxycarbazepine  arbazine on a study group. The researchers had 46 patients were over the age of 40 years old in the clinical trial. These people had new onset, previously untreated idiopathic trigeminal neuralgia. 24 patients were randomized to receive Oxycarbazepine  and 22 to receive Carbamazepine.

All patients over a two- to four-week period were given an initial dose 300 mg Oxycarbazepine  twice daily or 200 mg carbamazepine twice daily. This was then followed by a four-week maintenance period.

The most frequently doses used were Oxycarbazepine 750 mg per day and Carbamazepine 500 mg per day. Researchers noted that there were no significant differences between the groups for any efficacy variable.

In the two groups, 100% of patients responded to treatment and 50% became pain-free. 70% of those who were taking Oxycarbazepine had a significant reduction in pain compared to 59% of those who took Carbamazepine.

One patient in the Oxycarbazepine group discontinued treatment due to a rash.

The results that researchers gained from this study suggested that Oxycarbazepine is an effective treatment alternative to Carbamazepine for patients who suffer from new onset trigeminal neuralgia.

Oregon Health & Science University’s School of Dentistry have discovered a novel function of the peptide known as Nerve Growth Factor (NGF) in the development of the trigeminal nerve. The trigeminal nerve provides the signaling pathway for periodontal pain, dental surgical pain, and pain associated with temporomandibular disorder, trigeminal neuralgia, migraine, and other neuropathic and inflammatory conditions. The study is posted online in the journal Neuropeptides and will appear in print issues of that journal in early 2009.

(Media-Newswire.com) – Oregon Health & Science University’s School of Dentistry have discovered a novel function of the peptide known as Nerve Growth Factor ( NGF ) in the development of the trigeminal nerve. The trigeminal nerve provides the signaling pathway for periodontal pain, dental surgical pain, and pain associated with temporomandibular disorder, trigeminal neuralgia, migraine, and other neuropathic and inflammatory conditions.
The study is posted online in the journal Neuropeptides and will appear in print issues of that journal in early 2009.

Working with researchers in the dental school departments of Endodontology and Integrative Biosciences, second-year endodontology resident and lead author of the study, Leila Tarsa, D.D.S., M.S., found a new mechanism involved in establishing junctions – known as synapses – between trigeminal nerve cells. Nerve cells communicate with one another through chemicals called transmitters that are released at synapses. The transmitter release from nerve cells endings is possible only if aided by several molecules that are critical for proper function of the synapse. Tarsa’s research shows that NGF promotes transport of one of the molecules ( called synaptophysin ) from the nerve cell body to its ending.

“The data indicate that NGF participates in formation of neuronal connections in the trigeminal system,” said Agnieszka Balkowiec, M.D., Ph.D., OHSU School of Dentistry assistant professor of integrative biosciences and OHSU School of Medicine adjunct assistant professor of physiology and pharmacology, who is the senior author of the study and whose lab hosted the research. “This study has broad implications for trigeminal nerve regeneration.”

The study was supported by grants from the National Institutes of Health and the Medical Research Foundation of Oregon.

About OHSU

Oregon Health & Science University is the state’s only health and research university and Oregon’s only academic health center. ( excluding government ), with 12,700 employees. OHSU’s size contributes to its ability to provide many services and community support activities not found anywhere else in the state.