Trigeminal neuralgia is a condition that causes episodes of intense facial pain, which can significantly disrupt daily activities. It typically occurs when a blood vessel presses on the trigeminal nerve near the brainstem. This nerve plays an important role in transmitting sensations from the face to the brain.
Although not life-threatening, trigeminal neuralgia can greatly affect a person’s quality of life. Simple activities such as chewing, talking, smiling, or even brushing your teeth can trigger sudden, sharp pain. This is why the condition impacts not only physical health but also emotional well-being. Trigeminal neuralgia is generally chronic (long-term), but its symptoms can be managed with proper treatment.
One of the treatment options is Microvascular Decompression (MVD), a procedure designed to relieve pressure from blood vessels on the trigeminal nerve. This procedure can be performed by Dr. dr. Mardjono Joy Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS, also known as Dr. Joy, at Mandaya Royal Hospital Puri, helping to significantly reduce pain and improve patients’ quality of life.
Contents
What Are the Symptoms of Trigeminal Neuralgia?
The main symptom of trigeminal neuralgia is sudden, severe facial pain, usually affecting only one side. The pain is often described as an electric shock or stabbing sensation. During an attack, some people may also experience facial muscle spasms or twitching.
Between pain episodes, you may feel:
- Burning sensation
- Throbbing pain
- Numbness
- Dull, aching pain
In general, trigeminal neuralgia is classified into two types based on symptom patterns:
1. Paroxysmal trigeminal neuralgia
This type involves sudden, sharp, and intense pain that comes and goes. Episodes can last from a few seconds up to about two minutes. Although there are pain-free intervals between attacks, episodes can recur repeatedly for hours, even up to two hours.
2. Trigeminal neuralgia with continuous pain
This type is usually less intense but occurs more frequently. Patients may experience persistent pain, often described as stabbing or burning, along with ongoing discomfort. This type is often more difficult to manage.
Typically, trigeminal neuralgia affects only one side of the face (unilateral). In rare cases, it can affect both sides (bilateral), though not at the same time. Over time, the condition may worsen, with more frequent and longer-lasting pain episodes.
What Causes Trigeminal Neuralgia?
In general, trigeminal neuralgia occurs due to pressure on or damage to the trigeminal nerve. Based on the cause, it can be categorized into several types:
1. Primary (classic) trigeminal neuralgia
This is the most common type, occurring when a blood vessel (usually the superior cerebellar artery) compresses the trigeminal nerve root. This pressure makes the nerve more sensitive and triggers pain.
2. Secondary trigeminal neuralgia
This type occurs due to other conditions that affect or damage the trigeminal nerve, such as multiple sclerosis (MS), tumors, or arteriovenous malformations. Patients with secondary TN are usually younger and more likely to experience pain on both sides of the face. About 15% of cases fall into this category.
3. Idiopathic trigeminal neuralgia
In this type, no clear cause can be identified despite thorough medical evaluation.
What Are the Risk Factors?
Several factors may increase the risk of developing trigeminal neuralgia, including:
- High blood pressure (hypertension)
- Smoking
- Aging
- Female gender
- Family history of trigeminal neuralgia
How Is Trigeminal Neuralgia Diagnosed?
To establish a diagnosis, doctors will first ask about your symptoms and medical history. This is followed by a physical examination of the head and neck, as well as a neurological exam.
Diagnosis is typically based on several factors, such as:
- The type of pain you experience
- The exact location of the pain on your face
- Activities or movements that trigger the pain
Because several other conditions can also cause facial pain, doctors need to rule them out. These may include cluster headaches, migraines, postherpetic neuralgia, or temporomandibular joint (TMJ) disorders.
To determine the exact cause, doctors usually recommend a brain MRI. This imaging test helps identify whether a blood vessel is compressing the nerve or if a tumor is present.
MVD Procedure by Dr. Joy for Trigeminal Neuralgia
To effectively treat this condition, one of the recommended options is the MVD procedure, which aims to relieve pressure from blood vessels on the trigeminal nerve and address the root cause of irritation.
At Mandaya Royal Hospital Puri, this procedure is performed by Dr. Joy, a leading neurosurgeon in Indonesia. During the procedure, a small incision is made behind the ear to access the affected nerve. The blood vessel pressing on the nerve is then carefully separated, and a special cushion is placed between them to prevent future contact.
About Dr. Joy
Dr. Joy is a neurosurgeon with a subspecialty in cerebrovascular diseases. He is widely recognized for his expertise in managing various neurological disorders, particularly those involving brain blood vessel abnormalities.
He earned his doctoral degree from the University of Helsinki, with a research focus on brain aneurysms. His work explored how aneurysms develop and the clinical approaches used for diagnosis and treatment.
In addition to treating patients at Mandaya Royal Hospital Puri, Dr. Joy is also active in academia. He is the author of the book Memahami Aneurisma Otak (Understanding Brain Aneurysms), which has been published in two editions. The book provides a comprehensive overview of aneurysms, including causes, disease mechanisms, diagnostic methods, and available treatment options.
In his daily practice, Dr. Joy frequently handles complex neurological cases such as brain aneurysms, cerebrovascular stenosis, brain hemorrhage, brain tumors, and brain cancer.
With extensive clinical experience, strong academic background, and training from various international neurosurgical centers, Dr. Joy is regarded as one of Indonesia’s leading neurosurgeons, particularly in managing cerebrovascular and brain tumor cases.
Consultation Schedule
Dr. Joy is available for consultation at Mandaya Royal Hospital Puri on the following schedule:
- Monday: by appointment
- Tuesday: 14:00 – 17:00 WIB
- Wednesday: by appointment
- Thursday: 08:00 – 12:00 WIB
- Friday: 14:00 – 17:00 WIB
- Saturday: 08:00 – 12:00 WIB
To make your visit more convenient, you can use the WhatsApp Chat feature, Book Appointment service, or the Care Dokter app (available on Google Play and the App Store) to manage appointments, check queue numbers, and access more information.
