Trigeminal neuralgia is universally acknowledged as one of the most painful afflictions known to adults, affecting thousands of Americans each year. A form of microvascular nerve compression, trigeminal neuralgia causes episodes of intense, stabbing, electric shock-like facial pain. The pain results from blood vessels coming into contact with the fifth cranial (trigeminal) nerve and applying pressure to the nerve. The shock of this excruciating pain can actually cause a sufferer's head to snap back, or it can immobilize the individual. The pain attacks viciously and without warning. Left untreated it tends to worsen over time.

Patients with neurovascular problems, such as trigeminal neuralgia, hemifacial spasm, intractable vertigo and spasmodic torticollis, benefit from endoscopic surgical procedures. Surgeons perform this delicate microvascular decompression procedure through a dime-size opening behind the ear. Through this opening, surgeons insert a 2.7 mm endoscope. They can then identify the problem and perform the procedure - meticulously separating the nerve and blood vessel, and inserting a Teflon disk between them. Once the pressure has been relieved, patients often report immediate and complete relief from the pain.

In many cases, the endoscopic keyhole surgery is the preferred approach to traditional methods, in which instruments are inserted in a larger opening behind the ear and the brain is pushed aside to reach the nerve compression area.

The complexity of managing facial disorders requires a dedicated, multidisciplinary approach. Available at Cedars-Sinai Medical Center, this specialized service brings together Dr. Keith L. Black, Chairman, Department of Neurosurgery and Director of the Maxine Dunitz Neurosurgical Institute, and renowned pain specialist Dr. Stephen Graff-Radford, Director of The Pain Center at Cedars-Sinai Medical Center. Treatment alternatives include medical, surgical, psychological and pharmacological management - each customized to the patient's needs. Pain experts, surgeons, neurologists, psychologists and a full-time social worker closely collaborate to provide the most appropriate care for each patient.

For an in depth look at the condition, please read Dr. Graff-Radford's article in the Summer 2006 Neurosciences Report entitled "Trigeminal Neuralgia: Classification, Diagnosis and Treatment."