Learn about getting a comprehensive orofacial pain evaluation and become an educated patient.
Only about 1% of people with trigeminal neuralgia have their symptoms caused by a brain tumor. Pain caused by a vascular loop, or even pain caused by MS is much more common. Nevertheless, the possibility of a brain tumor is the most important reason that any person presenting with facial pain symptoms should undergo an MRI as part of the routine workup.
In the rare instance where a brain tumor is the cause, there are three types of brain tumors that may be: the first two are the two most common types of benign brain tumor: meningioma and schwannoma. Vestibular schwannomas (also known as acoustic neuromas) can cause facial numbness or pain only if they grow large enough to affect the trigeminal nerve. The third is a rare type of benign brain cyst tumor know as an epidermoid. It would be extremely rare for other types of brain tumors, including metastatic tumors and malignant brain tumors to cause trigeminal neuropathic pain. Tumors of the face involving the trigeminal nerve may also cause pain, but it would be unusual for pain caused by these tumors to be typical of neuralgia.
Undergoing an MRI during diagnostic testing should show the existence of a tumor and would provide you and your doctor information about how to proceed with treatment. Neurologists and neurosurgeons understand when and how to image the trigeminal nerve whenever the diagnosis of trigeminal neuralgia is considered.
In a series of 1,185 patients who underwent surgery for TN over a period of two decades by Dr. Peter Jannetta, less than 1%, or eight patients, had an associated acoustic neuroma (AN) tumor. In a series of 2,000 patients over one decade operated on by Dr. John Tew, only four patients had an associated AN. The patients in Dr. Tew’s series had numbness in their faces caused by the tumor, and one had burning pain, not the typical stabbing pain associated with TN. These observations may indicate what treatment is likely to be more effective.
Upon review of his treatment of his eight patients with AN, Dr. Jannetta concluded that the cause of their stabbing pain was the presence of an artery that had been pushed towards the trigeminal nerve by the expanding AN. It was not the tumor causing the neuropathic facial pain; rather, it was the compression of the nerve by the force of arterial pulsations. To cause TN, an AN has to grow large enough to come into contact with the trigeminal nerve.
If a tumor is compressing your trigeminal nerve, the goal of the surgery is to move that rtery off the nerve and maintain that separation with a small cushion- the same goal as an MVD surgery. The goal of radiation is to prevent tumor growth, not to make the tumor shrink or disappear; therefore, TN caused by a tumor will likely not be relieved. If the target is the trigeminal nerve, radiation may be an option.
There are neurosurgeons experienced treating tumors and trigeminal neuropathic pain who can discuss with you the options for treatment and help you to decide what the best one is for you.
Dr. Derek Steinbacher, Director of Craniofacial Surgery, Yale Medicine, Chief of Oral Maxillofacial Surgery and Dentistry, FPA Medical Advisory Board member, reviews migraines, TMJ disorders, and dental pain.
Dr. Wolfgang Liedtke will discuss medical treatment of trigeminal neuropathic pain with Dr. Jeffrey Brown.
Wolfgang Liedtke, M.D. Ph.D. is Chair of Neurology, Global Development Scientific Council at Regeneron Pharmaceuticals. Prior to that, he was Professor in the Departments of Neurology, Anesthesiology and Neurobiology; Attending Physician, Duke Neurology Clinics and Clinics for Innovative Pain Therapy, serving patients there for over 17 years.
Dr. Mark Linskey, Dr. Richard Zimmerman, and Megan Hamilton discuss what to look for in the decision making process when you are trying to find a doctor and treatment for facial pain.
Dr. Deborah Barrett offers a framework and tools to help people improve their quality of life, just as they are, while also reducing pain and suffering. Her work draws from empirically based cognitive and behavioral interventions, and she practices what she preaches every day.
Dr. Larry Arbeitman will answer: What is Upper Cervical Chiropractic? How does is differ from traditional Chiropractic methods? Learn about the connection between the Upper Cervical Spine and Facial Pain, research and case studies, what you can expect from UCC and how you can integrate it into your healthcare plan. You will also be able to ask Dr. Arbeitman your questions during this live presentation.
In this webinar, Dr. Jeffrey Brown, Chairman of the FPA Medical Advisory Board, talks about the top questions patients and their loved ones have regarding trigeminal neuralgia.
Jennifer M. Wagner, Executive Director of the Western Pain Society, explains the brain-body connection with an emphasis on pain response and provides a list of strategies for those affected by chronic pain.
Dr. Raymond Sekula, Professor of Neurosurgery at the University of Pittsburgh School of Medicine and Director of the Cranial Nerve Disorders Program at UPMC, and FPA Medical Advisory Board member reviews the challenges that can complicate the care of people with neuropathic facial pain.
Complementary health approaches, also referred to as complementary and alternative medicine (CAM), integrative health therapies, and other terms, refers to a group of diverse medical and health care systems, practices, […]
Dr. Jeffrey Brown, Chairman of the Facial Pain Association’s Medical Advisory Board, interviews Dr. Hossein Ansari on medical causes of neuropathic facial pain.
Neuropathic facial pain is diagnosed almost exclusively by the individual’s description of the symptoms. Dr. Kim Burchiel developed a list of questions to help doctors determine exactly which classification may describe a […]
Facial pain can be described in many words…but if you had to choose just one, what would it be? The YPC recently shared how we would describe TN in one word and how we plan to overcome TN.
Dr. Julie Pilitsis, Chair of the Department of Neuroscience & Experimental Therapeutics Professor of Neurosurgery Neuroscience and Experimental Therapeutics, Albany Medical Center and FPA Medical Advisory Board member presents an overview of trigeminal neuralgia and other neuropathic facial pains.
Dr. Konstantin Slavin discusses neuromodulation, a procedure used to treat and enhance quality of life in individuals who suffer severe chronic illness due to persistent pain.
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