Director & HOD – Neurosciences
Trigeminal neuralgia (TN) is a condition causing recurrent, severe, electric shock-like pain in the face, triggered by everyday activities such as eating, talking, or touching the face. It is one of the most painful conditions known — described as the 'suicide disease' — yet is highly treatable. The cause is usually compression of the trigeminal nerve (fifth cranial nerve) at its entry into the brainstem by an adjacent blood vessel. Treatment progresses from carbamazepine (first-line medication) through percutaneous procedures to microvascular decompression (MVD) surgery. At Medanta Hospital, Noida, Team Sushrut manages TN with all levels of therapy.
Symptoms
Treatments
Dr. Manish Vaish
Director and Head - Neurosciences
DNB. AANS International Fellow
Dr. Kapil Singhal
Director – Neurology
M.D. D.M
Dr. Namita Kaul
Director – Neurology
M.D. DNB
Dr. Anil Dhar
Associate Director – Neurosurgery and Stereotactic Radiosurgery
M.Ch.
Dr. Manish Marda
Director – Neuroanesthesia and Neurocritical Care
MD, DM
What is the most effective treatment for trigeminal neuralgia?
Microvascular decompression (MVD) surgery has the highest long-term pain relief rate — approximately 80% of patients are pain-free at 1 year and 70% at 10 years. It treats the underlying cause (nerve compression by a blood vessel) rather than the nerve itself. MVD requires a posterior fossa craniotomy; it is appropriate for younger, fit patients. Dr. Manish Vaish (AANS International Fellow) performs MVD at Medanta Hospital, Noida.
Is carbamazepine always the first treatment for trigeminal neuralgia?
Yes. Carbamazepine is the first-line evidence-based medication for trigeminal neuralgia and provides complete or near-complete relief in 60–80% of patients. Blood levels and blood count monitoring are needed. If carbamazepine is not tolerated or becomes ineffective, the next step is oxcarbazepine or alternative medications. Failure of or intolerance to medications is the indication for procedures or surgery.
Is trigeminal neuralgia a sign of MS?
In a minority of cases (approximately 2–4%), trigeminal neuralgia is caused by multiple sclerosis — a demyelinating plaque at the trigeminal root entry zone. MS-related TN is more common in younger patients and may be bilateral. MRI brain and spine is performed for TN patients under 50 to exclude demyelinating disease. Dr. Kapil Singhal and Dr Namita Kaul at Team Sushrut evaluates MS-related TN.
Where is MVD surgery for trigeminal neuralgia available in Noida?
Dr. Manish Vaish (AANS International Fellow) and Team at Medanta Hospital, Sector 50, Noida performs microvascular decompression (MVD) for trigeminal neuralgia. MVD is also called Jannetta procedure and is the surgery with the highest durable pain relief rate for classical TN. Contact Team Sushrut at +91 98103 24401.
