Pain-free after 7 years with trigeminal neuralgia

Diana Greene woke up at 2 a.m. with jabbing jolts of pain coursing through the left side of her head.

She crawled into her husband Rich's arms, wailing from the unfamiliar, shocklike pains that sent her facial muscles into spasms.

That was 1999, the beginning of her seven-year battle with trigeminal neuralgia. Greene grew to live with the sudden jolts of pain that she called "electrocutions" that would come from nowhere.

"Pain became my daily enemy," said Greene, of Tumwater Hill, Wash. "I would feel so blessed when I'd go two hours with no pain. And then, it would hit me with a vengeance."

Trigeminal neuralgia, also known as tic douloureux, is a condition that affects the trigeminal, or the fifth cranial nerve, one of the largest nerves in the head. About 45,000 people in the United States and about 1 million worldwide have the condition, according to the American Association of Neurological Surgeons.

It's caused by a malfunction of the nerve that's responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes.

It often is triggered by talking, brushing the teeth, touching the face, chewing or swallowing.

The disorder is more common in women than in men, and it rarely affects anyone younger than 50, according to the National Institute of Neurological Disorders and Stroke.

The cause remains unknown, as do prevention or cure.

"I'd tell people it's like going to the electric chair and having them kill you and saying, `It didn't work, we'll have to try it again tomorrow,"' Greene said.

She began to understand why the condition was nicknamed "The Suicide Disease," because people felt they would rather die than live with the excruciating and unpredictable pain.

At first, Greene sought out alternative treatments, including chiropractic care, acupuncture and reflexology.

Eventually, Greene resorted to painkillers, but she hated the side effects, which included skin rashes, nausea and sedation.

Greene said she tried to wait until she felt she no longer could take it before taking a morphine pill, which would knock her out for almost a day and leave her vomiting the day she woke up. But one night last fall, she noticed the painkillers seemed to be losing their effect too.

Greene used the Internet to research treatment options, including radiation that numbs the nerve, injections and brain surgery, including microvascular decompression surgery. She found information on an endoscopic technique performed by Dr. Hrayr Shahinian, director of the Skull Base Institute in Los Angeles.

While other surgeons perform microvascular decompression by opening the skull, Shahinian's team is one of the first to do the procedure endoscopically, by inserting a small scope into a dime-size opening behind the ear.

He separates the vessel from the nerve and places a small Teflon disk between the two without disturbing the brain.

Patients go home after about a 48-hour hospital stay and usually have a quicker recovery than those who undergo the traditional surgery.

The Skull Base Institute was able to schedule her surgery in a matter of days, March 20.

Greene made arrangements for the trip, though she knew her health insurance likely would deny coverage because it was an out-of-state procedure.

The surgery appears to have been successful; Greene said she hasn't felt any facial shocks.

Her incision was only a few inches. It was repaired with 10 tiny staples.

"I'm smiling and happy and pain-free and looking forward to some quality of life for a change," Greene said. "It was the magic he performed and the miracle I needed."