Trigeminal neuralgia and hemifacial spasm are debilitating disorders that cause pain or uncontrollable movements in the facial region.

Trigeminal neuralgia or tic douloureux is sometimes described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve (also known as cranial nerve V), which sends branches to the forehead, cheek, and lower jaw. It is usually limited to one side of the face.

Hemifacial spasm is a neuromuscular disorder characterized by frequent involuntary contractions (spasms) of the muscles on one side (hemi-) of the face (facial). The first symptom is usually an intermittent twitching of the eyelid muscle that can lead to forced closure of the eye. The spasm may then gradually spread to involve the muscles of the lower face, which may cause the mouth to be pulled to one side. Eventually the spasms involve all of the muscles on one side of the face almost continuously.

Both conditions may be caused by a nerve injury, or a tumor, or it may have no apparent cause. Most often hemifacial spasm and trigeminal neuralgia are caused by a blood vessel pressing on a nerve at the place where it exits the brainstem.

Both conditions can be surgically treated through a procedure called Microvascular Decompression (MVD). MVD involves microsurgical exposure of either the trigeminal nerve root or facial nerve root, identification of a blood vessel that may be compressing the nerve, and gentle displacement of it away from the point of compression. “Decompression" may allow the nerve to recover. This often results in pain relief (trigeminal neuralgia) or resolution of spasm (hemifacial spasm).

The doctors in the Neurosurgical Group of Texas confine their treatment of trigeminal neuralgia and hemifacial spasm to the Texas Medical Center hospitals, recognized around the world for excellence in state of the art medicine and neurosurgery.

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