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CyberKnife treatment to stop the pain of trigeminal neuralgia

Woman with hands on her temples with glasses in right hand
How to Stop the Pain of Trigeminal Neuralgia

If you suffer from trigeminal neuralgia, you know how painful it can be. What you may not know is that there are a number of effective treatments, including medication, surgery, and a powerful but painless kind of radiation therapy, like the kind delivered by the CyberKnife® Robotic Radiosurgery system. Unfortunately, trigeminal neuralgia is often misunderstood, and people can experience bumps on the road to finding relief. Many times, working with a team of experts from different specialties is the best way to find a solution.

Here’s what you should know about trigeminal neuralgia —and the treatments that can help you feel better.

The frustrating journey to a diagnosis

Trigeminal neuralgia is so rare that many nonspecialists don’t fully understand it, so people with the problem sometimes go from doctor to doctor for years before they get the correct diagnosis. The result can be years of suffering. Trigeminal neuralgia is sometimes called one of the most agonizing medical conditions in existence; those with the condition may feel excruciating pain (like electric shocks) in the jaw, cheek and other parts of the face—and it often gets worse as the years go by.

Getting the answers you need

Fortunately, there are many treatments for trigeminal neuralgia, even though patients are frequently told about only one or two of them. It can be helpful to work with a team of experts who combine their knowledge to find the right approach for your particular situation.

Working together, a neurologist, neurosurgeon and radiation oncologist can determine whether medication, surgery, or precisely targeted radiation therapy—like the kind delivered by the CyberKnife Robotic Radiosurgery system—will offer the most effective relief. “When you have everyone together in an integrated practice, patients don’t have to drive from specialist to specialist or wait months for their next appointment,” says Robert Kerr, MD, a neurosurgeon at Northwell Health the Institute for Neurology and Neurosurgery . “For people in desperate pain, that’s really important.”

Picking a treatment that fits

Anticonvulsant drugs and antidepressants are usually tried first to ease the pain of trigeminal neuralgia, even if you don’t have seizures or depression. These medications often work well, but some people still experience pain or describe a kind of “brain fog.” For them, brain surgery is an option; if a blood vessel in the brain is pressing up against the trigeminal nerve, moving the vessel may relieve irritation and stop the pain.

If those treatments aren’t effective, or if you can’t have or don’t want surgery, radiation therapy delivered by the CyberKnife Robotic Radiosurgery system can provide powerful relief. “It’s important to have a multidisciplinary approach, because when it comes to trigeminal neuralgia, no one is quite the same as anyone else,” says radiation oncologist Richard Byrnes, MD, Medical Director of CyberKnife of Long Island, part of Northwell Health. “Dr. Kerr and I work very closely together to find the approach that fits each patient.”

A painless, powerful therapy

Despite its name, there’s no cutting involved with the CyberKnife Robotic Radiosurgery system. Instead, it uses very precisely targeted radiation to desensitize the trigeminal nerve. That makes it easy to tolerate: You simply lie on a table for about an hour while treatment is delivered.

Unlike conventional radiation therapy, which uses a single beam of radiation, the CyberKnife Robotic Radiosurgery system aims numerous beams of radiation at its target from many different directions, focusing them with sub-millimeter accuracy. The problem spot on the trigeminal nerve gets a high dose of radiation, while the healthy surrounding tissue gets minimal exposure.

The treatment delivers effective relief with a low risk for side effects. It takes between three weeks and three months to feel the full benefit, but about 95 percent of patients become pain-free. For about 25 percent of patients, symptoms return after a couple of years; a second CyberKnife treatment or conventional surgery usually helps them gain control of the pain.  

“People with trigeminal neuralgia live from moment to moment in fear of pain—their lives revolve around it,” says Dr. Kerr. “That’s why it’s so rewarding to see them after they’ve gotten the right treatment. It gives them their life back again.”


To learn more about trigeminal neuralgia treatment options, contact Dr. Byrnes at CyberKnife of Long Island at (631) 864-5600 or Dr. Kerr at Northwell Health the Institute for Neurology and Neurosurgery at (631) 351-4840.

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