Imagine experiencing excruciating pain in your face and head, triggered by everyday activity like brushing your teeth, chewing or even talking. For Casey Pokoj, this extreme facial pain began subtly, and increased over time.

“It started in 2008 – gradual symptoms, where I noticed a slight tingling in the jaw, in the face, or sometimes the forehead, but just a tingle.” But a few months later, while chewing, he was suddenly struck by an extreme pain in his face – he describes is as “more painful than a root canal.” It was located in his lower jaw. Neither his dentist nor a dental hospital could find anything wrong, and the jaw pain just became worse and worse.

“I’d wake up with the pain; it would take me 15 minutes before I could work up the courage to brush my teeth.”

After two years of agony, Casey was finally correctly diagnosed with Trigeminal Neuralgia. The first treatment, medication, did not work. Eventually, he came to Detroit Medical Center, to DMC Neurosurgery Specialist Dr. Murali Guthikonda. “He gave me answers right away to make me more comfortable. He said there was no other option but surgery.”

According to Dr. Guthikonda, Trigeminal Neuralgia causes intense face pain and jaw pain, affecting the patient’s lifestyle. Brushing teeth, even simply touching their face, can trigger the pain. The face pain can be so excruciating that it doesn’t respond to medications. All that face pain and jaw pain can be so severe that patients can seclude themselves – even a breeze can trigger the pain. They may stop eating, lose weight, and even become suicidal.

In the back of the brain is the trigeminal nerve. With Trigeminal Neuralgia, an artery is sitting on top of that nerve. As the heart beats, the artery strikes the nerve, which can lead to injury of the nerve and the electrical impulses that trigger the severe jaw pain or face pain.

The best treatment for Trigeminal Neuralgia is microvascular decompression surgery. Microvascular decompression means relieving the compression on the small trigeminal nerve. The surgery starts with a small incision behind the ear, allowing the DMC neurosurgery specialist to make an opening in the cranium, find the trigeminal nerve and the artery, and using a powerful microscope, separate the two structures. Once separated, a felt-type material is placed between the artery and the trigeminal nerve and the artery, padding and separating the two structures.

“The success rate for Microvascular Decompression in a patient with typical symptoms of severe, electric-like pains is almost 95 percent,” says Dr. Guthikonda. “As soon as the procedure is done, they wake up in the recovery room with no pain. It is that instantaneous.”

It certainly was for Casey. “I started tapping on my cheek, my jaw, my head – I had no pain! I felt like I wanted to dance in the hallway! I’d put my life in Dr. Guthikonda’s hands, because he saved me."

To schedule an appointment with Dr. Murali Guthikonda, or any DMC Neurosurgery Specialist, call 888-DMC-2500.