Facial Pain Clinic · Hyderabad
Trigeminal Neuralgia Treatment in Hyderabad
Fellowship-trained neurosurgeon Dr. Sayuj Krishnan offers the full spectrum of trigeminal neuralgia care—from medication optimisation to microvascular decompression (MVD), Gamma Knife radiosurgery, and percutaneous procedures—at Yashoda Hospital, Malakpet.
Understanding Trigeminal Neuralgia
Trigeminal neuralgia (TN) causes sudden, electric shock-like facial pain. Attacks may last seconds, cluster throughout the day, and be triggered by seemingly harmless activities such as brushing teeth, eating, smiling, or feeling a gust of wind. Most classical cases occur when a blood vessel compresses the trigeminal nerve at the brainstem. Secondary TN can stem from multiple sclerosis, tumours, or facial trauma, making specialist evaluation vital.
Early consultation allows us to separate classical TN from conditions that mimic it—atypical facial pain, cluster headache, dental issues, or sinus pathology. Getting the diagnosis right ensures we choose the safest path forward.
Common Symptoms & Triggers
- • Shock-like, stabbing facial pain lasting seconds to minutes
- • Pain typically restricted to one side (cheek, jaw, or forehead)
- • Triggers include touch, chewing, speaking, shaving, or wind
- • Anxiety about daily activities due to fear of triggering attacks
- • Background aching between episodes in mixed variants
Our Diagnostic Workflow
- Detailed history and neurological examination, mapping trigger zones and assessing cranial nerve function.
- High-resolution MRI brain with CISS/FIESTA sequences to visualise vascular compression, demyelination, or masses.
- MR angiography or CT angiography when vascular anatomy needs further definition.
- Dental or ENT consultation when symptoms suggest peripheral causes.
- Facial pain board review to align medical and surgical plans.
Treatment Pathways We Offer
1. Medication Optimisation
Carbamazepine and oxcarbazepine remain first-line. Alternatives such as gabapentin, baclofen, or lamotrigine are introduced if side effects emerge or control wanes. We monitor sodium levels, liver function, and blood counts to keep therapy safe.
2. Microvascular Decompression (MVD)
Through a small craniectomy, the compressing vessel is separated from the trigeminal nerve with a Teflon pad. With neuronavigation and neuromonitoring, MVD delivers the highest chance of durable pain freedom—over 70% at ten years in specialty centres.
3. Gamma Knife Radiosurgery
Outpatient stereotactic radiosurgery is ideal for patients who prefer a non-open option or have comorbidities. Relief typically builds over several weeks; dosing is planned to preserve normal sensation.
4. Percutaneous Procedures
Balloon compression, radiofrequency rhizotomy, or glycerol rhizolysis provide rapid relief, often as day-care procedures. They are useful for recurrence after MVD or when immediate pain control is required.
5. Managing Secondary TN
When MRI shows a tumour, aneurysm, or demyelinating plaque, the care plan focuses on that underlying cause. Our team coordinates neurology, oncology, and rehabilitation inputs so every aspect is covered.
Recovery & Long-Term Follow-up
After MVD
ICU monitoring for 24 hours and discharge by day three for most patients. Desk work often resumes in about two weeks; heavy lifting waits four to six weeks.
After Radiosurgery
Same-day discharge with follow-up at six weeks and three months. Medication taper starts once durable relief is confirmed.
After Percutaneous Care
Day-care procedure with transient numbness expected. Review within a week ensures sensation is settling and pain remains controlled.
When to Seek Urgent Attention
- • Severe pain despite medication titration
- • Medication side effects such as imbalance or allergic rash
- • Facial numbness, double vision, or weakness
- • Pain switching sides or becoming constant and burning
Frequently Asked Questions
Is trigeminal neuralgia curable?
Many patients achieve sustained pain relief with procedures such as microvascular decompression or radiosurgery. Recurrence can happen, so structured follow-up remains important.
How long does Gamma Knife radiosurgery take to work?
Relief is gradual. Most people notice improvement two to eight weeks after treatment, and medicines are tapered only when symptoms remain controlled.
What are the risks of MVD?
Serious complications are uncommon, particularly with neuromonitoring. Potential risks include hearing changes, facial numbness, or cerebrospinal fluid leak, all discussed before surgery.
Can trigeminal neuralgia return after treatment?
Yes, especially years later. Recurrence does not rule out further treatment—repeat MVD, radiosurgery, or percutaneous options can still help.
Is medication enough for everyone?
Medicines control pain for many people, but side effects or breakthrough pain may prompt procedures. We decide together based on symptom control and MRI findings.
Dr. Sayuj Krishnan, Neurosurgeon
Room 317, OPD Block, Yashoda Hospital, Malakpet, Hyderabad, Telangana 500036
Phone: +91 9778280044 · Email: neurospinehyd@drsayuj.com
Authored by: Dr. Sayuj Krishnan S, Neurosurgeon
Reviewed by: Dr. Sayuj Krishnan S, Board Certified Neurosurgeon
Last reviewed: 14 February 2025
Disclaimer: This content is for informational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment.