Which is the best hospital for Trigeminal Neuralgia in Coimbatore?

KG Hospital is the best hospital for Trigeminal Neuralgia treatment in Coimbatore. The neurosurgery team offers the complete range of TN treatments: Microvascular Decompression (MVD) — gold-standard surgery with 80–90% long-term pain-free rate and preservation of facial sensation — Glycerol Rhizotomy, and Radiofrequency Thermal Lesioning. Treatment is selected based on patient age, fitness, MRI findings, and preference.

What is Trigeminal Neuralgia and what does it feel like?

Trigeminal Neuralgia causes sudden, severe, electric shock-like or stabbing facial pain on one side of the face. The pain comes without warning and lasts from a fraction of a second to a few minutes. It is triggered by everyday activities: eating, speaking, brushing teeth, or even a light touch on the face. It is considered one of the most painful conditions in medicine. Between attacks there may be no pain at all, but severe cases can have many attacks per day.

What is Microvascular Decompression (MVD) for Trigeminal Neuralgia?

MVD is the gold-standard surgical treatment for TN. Through a small craniotomy behind the ear, the neurosurgeon — using the TIVATO 700 surgical microscope — identifies the blood vessel compressing the trigeminal nerve, repositions it, and places a soft Teflon pad between them. MVD provides 80–90% long-term pain-free rate with preservation of all facial sensation. It is the only TN treatment that addresses the root cause without damaging the nerve.

What is the success rate of MVD for Trigeminal Neuralgia?

MVD has a long-term pain-free rate of 80–90% — the highest of any TN treatment. Pain relief is typically immediate post-operatively for most patients. Unlike Glycerol Rhizotomy (which may need to be repeated) and Radiofrequency Lesioning (which provides 3–4 years of relief), MVD provides durable long-term relief. Facial sensation is fully preserved because the nerve itself is not damaged.

How long is recovery after MVD surgery?

Most MVD patients are discharged in 3–5 days. Full recovery is typically 2–4 weeks. Driving can be resumed at 4–6 weeks. Medications (carbamazepine) are gradually tapered and stopped over the months following successful MVD — most patients no longer require any TN medication.

What is Glycerol Rhizotomy and when is it used?

Glycerol Rhizotomy is a minimally invasive percutaneous procedure for TN. A thin needle is guided through the cheek under X-ray fluoroscopy to the trigeminal cistern at the skull base. Glycerol is injected, selectively damaging pain fibres. It is a day procedure, provides ~80% initial pain relief, and is preferred for elderly patients or those with comorbidities making open surgery high risk. Pain can recur and the procedure may need to be repeated.

How do I book a Trigeminal Neuralgia consultation at KG Hospital?

Call 0422-2219191 or 0422-4042121 for a neurosurgery OPD appointment. Bring your most recent MRI with report (ideally with dedicated trigeminal nerve sequences). Your neurosurgeon will review your history, examine you, review your MRI, and recommend the most appropriate treatment.

Trigeminal Neuralgia Treatment in Coimbatore | MVD Surgery

Q: What causes Trigeminal Neuralgia?

The primary cause of classical TN is a blood vessel (usually the Superior Cerebellar Artery) pressing on the trigeminal nerve root at its entry into the brainstem. This chronic pulsatile compression damages the nerve's protective myelin sheath, leading to abnormal electrical discharge and the characteristic pain. Less common causes include Multiple Sclerosis (MS plaques at the trigeminal nucleus), or a tumour at the cerebellopontine angle. MRI identifies the cause in most patients.

Feature	MVD	Glycerol	RF Lesion
Type	Open Surgery	Percutaneous	Percutaneous
Pain-free rate	80–90%	~80%	~75%
Durability	Long-term	May recur	3–4 years
Face sensation	Preserved	Usually preserved	Some numbness
Hospital stay	3–5 days	Day procedure	Day procedure
Best for	Fit, young	Elderly, high risk	Elderly, high risk

What It Is

What Is Trigeminal Neuralgia?

Trigeminal Neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve — the fifth cranial nerve, and the largest of the cranial nerves. The trigeminal nerve carries sensation from the face to the brain, covering three divisions: the forehead and eye (V1), the cheek and upper jaw (V2), and the lower jaw and chin (V3).

TN causes sudden, severe, electric shock-like or stabbing facial pain that comes without warning and disappears as quickly as it arrived. The pain is typically on one side of the face and lasts from a fraction of a second to a few minutes. Between attacks, there may be no pain at all. However, attacks may occur many times a day and can be completely disabling.

Trigeminal Neuralgia is considered one of the most painful conditions known to medicine — it has been called the “suicide disease” because of the severity of untreated pain. However, with modern treatment — particularly MVD surgery — most patients can achieve long-term, durable pain relief.

Key Facts

Considered one of the most painful conditions known to medicine

Electric shock-like pain lasting seconds to minutes per attack

Triggered by eating, speaking, brushing teeth, or light touch

Usually affects one side of face only

MVD surgery: 80–90% long-term pain-free rate

MRI essential before treatment to identify cause and plan surgery

Symptoms & Causes

Symptoms, Triggers & Causes of TN

Characteristic Symptoms

Sudden severe pain: electric shock, stabbing, or shooting pain in the face — comes without warning

Duration: seconds to 2 minutes per episode; attacks may cluster many times per day

Location: cheek, jaw, teeth, gums, lips; V2 (upper jaw) and V3 (lower jaw) most commonly affected; V1 (eye, forehead) less common

Laterality: almost always unilateral (one side). Bilateral TN is rare and warrants investigation for MS.

Between attacks: pain-free periods between episodes; in later stages, a dull ache may persist

Common Triggers

› Eating or chewing

› Talking or smiling

› Brushing teeth

› Light touch on the face

› Wind or cold air

› Washing the face

› Applying makeup

› Swallowing

What Causes Trigeminal Neuralgia?

Primary Cause: Vascular Compression (Classical TN)

In the majority of TN patients, a blood vessel — usually the Superior Cerebellar Artery (SCA) or Anterior Inferior Cerebellar Artery (AICA) — presses against the trigeminal nerve root at its entry zone into the brainstem. This chronic pulsatile compression causes demyelination (damage to the protective sheath) of the nerve fibres, leading to abnormal electrical discharge and the characteristic pain.

Multiple Sclerosis (MS)

MS plaques can form at the trigeminal nucleus or nerve, causing TN. MS-related TN is more often bilateral. MRI identifies MS plaques and distinguishes MS-TN from classical vascular TN.

Tumour or Vascular Malformation

Occasionally a tumour at the cerebellopontine angle (acoustic neuroma, meningioma) or a vascular malformation compresses the trigeminal nerve. MRI identifies these secondary causes and guides treatment planning.

Treatment Options

Trigeminal Neuralgia Treatment at KG Hospital

KG Hospital offers the complete range of Trigeminal Neuralgia treatments — from first-line medications through to definitive surgical cure. Treatment is selected based on patient age, general health, MRI findings, and preference.

Medication — First Line

Carbamazepine (Tegretol) or Oxcarbazepine are the first-line treatments. They reduce nerve firing and control pain in most patients initially. Over time, doses need to increase and side effects (drowsiness, dizziness, hyponatraemia) may become intolerable. When medications fail, surgical options are considered.

Microvascular Decompression (MVD)

Gold-standard surgery. Small posterior fossa craniotomy behind the ear. Offending vessel identified, repositioned, and a soft Teflon pad placed between vessel and nerve. 80–90% long-term pain-free rate. Facial sensation fully preserved. Best option for fit patients.

Gold Standard

Glycerol Rhizotomy

Percutaneous minimally invasive procedure. Thin needle guided under X-ray fluoroscopy through the cheek to the trigeminal cistern at the skull base. Glycerol injected to selectively damage pain-carrying fibres. Day procedure. ~80% initial pain relief. May need repetition as pain can recur.

Radiofrequency Thermal Lesioning

Percutaneous procedure under fluoroscopic guidance. A probe is advanced to the trigeminal ganglion and radio-frequency heat is applied to selectively destroy pain fibres. Provides 3–4 years of relief. Some facial numbness expected post-procedure. Day procedure.

Gold Standard Surgery

Microvascular Decompression (MVD) The Definitive Treatment

Microvascular Decompression (MVD) is the most effective and durable treatment for Trigeminal Neuralgia and addresses the root cause directly: the blood vessel compressing the trigeminal nerve root. It is the only TN treatment that does not damage the nerve itself.

The procedure is performed under general anaesthesia through a small craniotomy behind the ear (posterior fossa approach). The neurosurgeon — using the TIVATO 700 surgical microscope for magnification and illumination — identifies the trigeminal nerve root at its entry into the brainstem. The offending blood vessel is gently separated from the nerve and a soft Teflon pad is placed between them to prevent re-contact. The craniotomy is then closed.

There is no destruction of any part of the trigeminal nerve. Facial sensation is fully preserved. Pain relief is typically immediate upon waking from anaesthesia in most patients.

When MVD is the Right Choice

MVD is preferred for: patients in good general health with classical TN (vascular compression confirmed on MRI), younger patients requiring long-term durable relief, patients who have failed medication, and patients for whom facial numbness (a consequence of ablative procedures) would be unacceptable.

MVD at KG Hospital — Key Facts

80–90% long-term pain-free rate

Highest of any TN treatment available

Facial sensation fully preserved

Unlike ablative procedures which cause numbness

Pain relief immediate

Most patients wake from anaesthesia pain-free

Addresses root cause

Vessel decompressed — nerve not damaged

TIVATO 700 microscope

Precision magnification for every MVD procedure

Hospital stay 3–5 days

Full recovery 2–4 weeks · MRI confirms anatomy pre-op

Am I Suitable?

Who is a Candidate for Each Treatment?

Treatment selection depends on general health, age, MRI findings, medication history, and the patient’s priorities. Below is a guide — your neurosurgeon will review your specific situation.

✓ Good MVD Candidates

Fit for general anaesthesia and posterior fossa surgery

Classical TN with vascular compression visible on MRI

Age typically under 70 (though elderly patients with good fitness also benefit)

Failed medications (carbamazepine/oxcarbazepine) or intolerable side effects

Preference for long-term durable relief with preserved sensation

No previous major posterior fossa surgery

→ Percutaneous Procedures Preferred

Elderly patients or significant comorbidities making general anaesthesia high risk

Patients who decline open surgery

No compressing vessel identified on MRI (Glycerol / RF still effective)

TN due to multiple sclerosis (ablative procedures more appropriate)

Previous MVD with TN recurrence (re-operation possible but percutaneous simpler)

Patient accepts possibility of facial numbness as acceptable trade-off

What to Expect

Your MVD Patient Journey at KG Hospital

From first consultation to return to normal life — here is what a typical MVD patient journey looks like at KG Hospital Coimbatore.

Neurosurgery Consultation & MRI Review

Your neurosurgeon reviews your history and your MRI. A high-quality MRI with dedicated trigeminal nerve protocol sequences (FIESTA/CISS) is required to visualise the compressing vessel. If your current MRI is inadequate, a repeat study is requested. Your neurosurgeon will explain treatment options and recommend the most appropriate approach.

Day 1 — OPD consultation, 45–60 minutes

Pre-operative Assessment

Blood tests, ECG, chest X-ray, and anaesthesia assessment. Any medical conditions (hypertension, diabetes, anticoagulants) are optimised. Anticoagulants and antiplatelet drugs are usually stopped 5–7 days before surgery. Admission to hospital the evening before or morning of surgery.

1–2 days before surgery

MVD Surgery

General anaesthesia. A small incision behind the ear, a 3–4 cm circular craniotomy in the posterior fossa. The TIVATO 700 microscope is used throughout. The trigeminal nerve root is identified. The compressing vessel is identified, gently mobilised, and a Teflon pad placed. The incision is closed.

2–3 hours in theatre

Post-operative Recovery

Recovery in Neuro ICU overnight. Common post-operative symptoms: mild headache (managed with analgesia), facial numbness in the surgical area (temporary), and occasionally some nausea. Most patients report their TN pain is gone on waking. Eating and drinking typically resumable the following day.

First 12–24 hours in Neuro ICU

Ward Recovery

Transfer to neurosurgery ward. Physiotherapy for mobilisation. Wound check. Discharge with oral analgesia, wound care instructions, and a follow-up appointment. Most patients are eating and mobile within 24–48 hours. Medications (carbamazepine) are gradually tapered over 4–6 weeks under neurology guidance.

Days 1–4 post-surgery

Discharge & Follow-up

Discharge day 3–5. Driving resumable at 4–6 weeks. Full return to work in 2–4 weeks depending on occupation. Follow-up at 2 weeks (wound check), 6 weeks, and 3 months. Carbamazepine is gradually reduced and stopped in the months following successful MVD — most patients no longer need medication.

Day 3–5 — discharge home