Functional Neurosurgery

Trigeminal Neuralgia

Trigeminal neuralgia is known as one of the most severe pain and is extremely rare under the age of thirty. Patient may become unable to perform daily activities and even vital functions so it is a serious condition that should be diagnosed as soon as possible and treated.

Trigeminal neuralgia is structural differences and impairment of vascular formations surrounding the trigeminal nerve, which is one of the 12 pairs of nerves that directly come out of the brain. In addition, differences in bone structure, benign or malignant masses in the head, blows to the head, failed dental treatments, former infections may also cause trigeminal neuralgia.

The pain is short-term (from a few seconds to a minute or two), recurrent, like an electric shock in part of the face where the trigeminal nerve spreads. Generally, there are points on the outer part of the face, inside the mouth which trigger pain. For this reason, the patient doesn't touch these regions and avoids functions like washing face, brushing teeth, or even eating.

Drug therapy is first-line treatment in the case of trigeminal neuralgia. When drug treatment fails to provide adequate pain control or ceases to be effective, glycerin is injected in order to cut the nerve message or fibers that transmit pain are burned. In the case of surgical treatment, the pressure on the nerve in the brain stem is removed. Keeping in mind the patient's age and state of health, the most appropriate method is determined by the physician.

Spasticity Surgery

In spasticity, muscles are constantly in contracted state. Solid or strained muscles due to contraction prevent normal activities such as walking, movement and speech. While there are many causes of spasticity in children, the majority is comprised of brain damage due to oxygen deficiency, brain trauma, stroke or various forms of nervous system damage. Certain metabolic disorders can also lead to spasticity.

In spasticity, there are many symptoms, including inability to bend limbs, joints twisted in unusual angles, crossing arms or legs, speech problems. In the long term, spasticity can lead to the fact that muscles contract joints and fix them permanently in a single position.

Physical therapy is an important treatment for spasticity and a daily regimen of a series of joint movements, exercise and stretching movements that help reduce the severity of symptoms. Drug therapy can be performed by oral administration or drug injection directly to the corresponding region. Surgical treatment should be applied for severe chronic spasticity. During surgical treatment, orthopedics and neurology disciplines should work together. Orthopedic treatment involves tendon, muscle and bone extension methods to provide movement and flexibility. Neurosurgeons contribute to the treatment by an operation which involves cutting sensory nerves that carry information to spastic limbs.

Facial Twitches

Facial twitches refer to involuntary, painless contraction of facial muscles at intervals. They typically begin around the eye, and then spread to other facial muscles around the mouth. Twitches may last for one or several minutes. Twitches mostly increase with fatigue, stress, anxiety and excitement while they decrease during rest and sleep.

Facial twitches are most common between the ages of 40-60 and affect women twice as much as men.

It has been reported to be more frequently seen in people of Asian descent and the reason for this is that the people living in this region have a cerebellum bone with smaller volume. Face twitching is not inherited; it usually occurs as a result of other diseases. Head trauma, brain tumors, cerebrovascular diseases and stress are external factors that cause facial twitching.

In mild cases of facial twitching, often drug therapy and botox are applied. In case of failure of botox treatment or in advanced clinical cases, surgical method is preferred.