Health Advise

by / Friday, 10 July 2020 /
Post Image By Dr. dr. Julius July, SpBS, MKes
Specialis Bedah Saraf, Siloam Hospitals Lippo Village


Known as a medical term Trigeminal Neuralgia, pain in part of the face or jaw turned out sourced from the fifth nerve in in the head. This nerve is called also by the name of Trigeminus. Latin, Trigeminus comes from the word "tri" meaning "three" and "Gemini" means "pairs/ twins". Ideally, we do have a pair of Trigeminus nerves, which are on the left and right.

Each of these nerves consists of three branches, which are when viewed from the front, it will look like three pairs of nerves on the face. First branch towards the forehead area, branches second to the cheeks, and branches third towards the jaw. That’s why when there is interference in the Trigeminus nerve, you can cause pain in one or more parts of the face.

In many cases, pain often occurs in the jaw so it is often considered to be a toothache. As a result, many of the patients went to the dentist. In fact, when examined by a dentist, there is actually no problem with your teeth. You will instead be referred to a neurologist or neurosurgeon. There are also cases where patients go through a tooth extraction procedure because there are indeed problems with their teeth. However, after the tooth is removed, the pain does not go away. This is because the main cause of pain is the blood vessels attached to the base of the Trigeminal nerve. Thus, irritation continues to follow the pulse of the arteries. However, there are also several other causes, but the incidence is relatively rare, namely tumors, inflammation, and the former infection. Usually patients are required to do an MRI examination to make sure.

However, there is no need to worry. There is a solution that can help you.
Take medicine such as Carbamazepine (Tegretol), injections in the ganglion, surgery, and Gamma Knife. So far, the best treatment solution from meta-analysis studies worldwide is surgery, which is known by the medical term "Microvascular Decompression" (MVD). The action taken is quite simple, namely installing a Teflon wedge (artificial cotton) between the blood vessels and the base of the Trigeminal nerve, exactly where it is attached.

With these surgical procedures, the patient can be free of pain without medicine for a long time. Based on meta-analysis results all over the world, the statistics are even reach ten years with 70% percentage. Not only that, the possibility of complications during surgery also tends to be low, around 1-1%. Do not miss the time period of treatment which only takes 2-3 days.

Not only that, the possibility of complications during surgery also tends to be low, around 1% -2%. Do not miss the time period of treatment which only takes 2-3 days.




Picture 2:
Left – vessels blood attached to Trigeminus side nerve base left
Right – after being propped up Teflon between vessels Trigeminus blood and sarfa, visible blood vessels sitting on the Teflon. Provision of Fibrin Glue done to maintain the position.

Picture 1: Trigeminus' nerve branches to the forehead, cheeks and jaw. Visible blood vessels attached to the nerve base.


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