Q&A – Tumors of the trigeminal nerve can cause severe facial pain
Dr. Yair Gozal, neurosurgeon, Mayfield Brain & Spine
Q: What is the trigeminal nerve?
A: The trigeminal nerve is a cranial nerve that originates in the brainstem and divides into three branches, with each branch supplying sensation to a different area of the face.
Q: How does a tumor on the trigeminal nerve affect a patient?
A: Depending on its size, location and proximity to the nerve, a tumor that puts pressure on the trigeminal nerve can cause severe facial pain, stiffness or numbness in the face or jaw. These symptoms can make daily activities difficult, such as eating or brushing your teeth.
Q: If the problem is farther from the base of the trigeminal nerve, are the symptoms different?
A: Yes, symptoms can vary based on whether the pressure on the nerve is close to the brainstem or closer to the outer end of the nerve, called a distal location. If the trigeminal nerve is under pressure close to its origin, it can affect the entire face. Once the nerve divides into several branches, any impingement will be specific to one area of the face.
Q: What is the difference between a tumor on the trigeminal nerve and trigeminal neuralgia?
A: Both of these are disorders affecting the trigeminal nerve, which originates in the brainstem and controls sensation to the face. Trigeminal neuralgia is a neurologic disorder caused by a vessel, such as an adjacent artery or vein, putting pressure on the trigeminal nerve, creating severe facial pain that often feels like tiny electric shocks in the face. Treatments can include surgery or targeted radiation, called radiosurgery. A tumor on the trigeminal nerve or growing out of the trigeminal nerve is compressing the nerve and can cause facial pain. Open brain surgery to remove the mass, and in some instances radiosurgery, may be recommended treatments.
Q: What are potential treatments?
A: Treatment can include medication to control symptoms and close observation to keep track of the size of the tumor. If your surgeon recommends that the tumor needs to be removed, traditional cranial surgery to remove the tumor can eliminate the source of pressure on the trigeminal nerve.
Q: What is the main factor in determining if surgery is necessary?
A: The main factors will include the severity of the symptoms and the size and growth of the tumor. If the patient’s facial pain can be controlled through medication, surgery might not be necessary in the short term. If the tumor continues to grow, it might indicate that surgery is the recommended option.
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