From Severe Pain to Relief: A Neurosurgeon’s Encounter with Trigeminal Neuralgia - Dr Laxminadh Sivaraju

When Mrs L, a 52-year-old teacher, first walked into my clinic, her face told a story of exhaustion and fear. She had been living with a mysterious pain for nearly three years, sharp, stabbing jolts on the right side of her face that came without warning.

She had visited dentists who extracted healthy teeth, consulted ENT specialists who prescribed antibiotics for sinusitis, and even tried migraine medications. Nothing worked.

By the time she reached us, she was terrified of brushing her teeth, chewing food, or even stepping out on a breezy day, because the slightest trigger could unleash another attack.

The Hidden Face of Pain

As a neurosurgeon, I have seen many conditions cause suffering, but Trigeminal Neuralgia stands apart. Often called the “suicide disease,” its pain is so severe that patients live in constant anticipation of the next jolt.

The culprit is the trigeminal nerve, which carries sensations from the face to the brain. When this nerve gets irritated, usually by a nearby blood vessel pressing against it, it misfires, sending shock-like pain signals for the simplest of activities.

The tragedy is not just in the pain, but in the journey patients take before reaching the right diagnosis. Many go through years of unnecessary treatments, each failed attempt adding to their hopelessness.

Why the Diagnosis is Missed

I often ask my patients what they were told before reaching us. The answers follow a familiar pattern:

• “My dentist thought it was a root canal issue.”

• “The ENT said it must be sinus infection.”

• “Someone told me it’s just migraine.”

The confusion is understandable. Facial pain is common, but Trigeminal Neuralgia has a unique fingerprint, sudden, electric shock-like jolts lasting seconds to minutes, triggered by touch, chewing, or even speaking.

Unlike migraines, there’s no aura or nausea. Unlike sinus pain, there’s no congestion. Unlike dental pain, extractions don’t help.

But unless you’ve seen this condition before, it’s easy to mistake it for something else. And every delay makes the patient’s suffering worse.

When Medicines Aren’t Enough

When Mrs. L finally received the right diagnosis, we began with medication, the first line of defence. For many, these drugs calm the nerves and provide relief But in her case, the medicines only dulled the pain for a while, then stopped working.

The side effects, dizziness and fatigue, made her teaching job nearly impossible. It was then that I spoke to her about surgery.

Understandably, she was frightened. Brain surgery is not a decision patients take lightly. But when the choice is between a life ruled by pain and the possibility of lasting relief, many find courage they didn’t know they had.

The Turning Point

Mrs. L underwent Microvascular Decompression, a procedure where we gently separate the blood vessel compressing the trigeminal nerve and cushion it to prevent further irritation. It’s a delicate surgery, but one with some of the best long-term outcomes for this condition.

The morning after her surgery, she sat up in bed with tears in her eyes, not from pain, but from relief. For the first time in years, she could smile without fear.

What Her Story Teaches Us

Every patient with Trigeminal Neuralgia reminds me that timely diagnosis is as important as treatment itself. Had Mrs L known earlier that her pain wasn’t dental, sinus, or migraine-related, she could have been spared years of unnecessary suffering.

The lesson is simple: if facial pain is electric, brief, and triggered by touch or chewing, it deserves evaluation by a neurologist or neurosurgeon.

Modern surgical options, from Microvascular Decompression to less invasive radiosurgery, now offer durable relief and give patients their lives back.

A Note to Patients

As doctors, we measure success not only in operations performed but in lives restored. Watching Mrs L return to her classroom pain-free, after nearly giving up hope, was a reminder of why we do what we do.

Trigeminal Neuralgia may be rare, but for those who suffer from it, awareness and early specialist care can make the difference between years of agony and a future filled with relief.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.