Patients with trigeminal neuralgia (TN) often receive outpatient treatment, but for some, like a 54-year-old male in this case, symptoms can become so severe and frequent that they dramatically reduce quality of life, leading to hospitalization and potential suicidal thoughts.
A variety of medical therapies, including gabapentin and opioids, were ineffective for this patient, highlighting the challenge of managing extreme TN pain with medication alone.
Ultimately, surgical intervention through a craniectomy resolved his symptoms, underscoring the need for earlier consideration of surgical options and a multi-disciplinary approach to treatment in difficult cases.