Jimmie Vance, Trigeminal neuralgia treatment

The lasting pain that forced a disruption in his life for more than a decade had finally peaked and 68-year-old Jimmie Vance finally reached his breaking point. The pain went down his face and around the side of his head. The sharp, electric-like pain came in short bursts but, as time went on, the pain was more intense, and he never really knew when it would occur again.

“You talk about pain … it was pain,” Vance says as he holds his head from the memory. “I never knew when it would hit, but the vibrations of shaving always set it off and sometimes eating. It was unbearable, and it really affected my life. It was the worst pain I ever had.”

The pain was trigeminal neuralgia; considered to be one of the most painful conditions in medicine which a person suffers repeated episodes of severe sudden burning or shock-like facial pain. It is often called the suicide disease because a significant number of patients have taken their lives due to the extreme pain. Trigeminal neuralgia is usually caused by a blood vessel pressing on the trigeminal nerve in the head where it exits the brain stem. Painful attacks may be triggered by normal activities such as brushing teeth, chewing, drinking and shaving.

“We used to find Jimmie sitting on the back porch in his rocker and he would be holding his face in his hands,” says Maedell, Vance’s wife of 46 years. “We didn’t know what was going on with him, and everyone was worried.”

Vance was taking medication for years to help control the attacks. Eventually, he found that medication was not working for him anymore and needed to seek additional treatment options. Vance’s neurosurgeon recommended he speak with Dr. Robert Bertoli, a radiation oncologist at the University of Tennessee Medical Center. “My wife and I met with Dr. Bertoli about my options,” Vance explains. “He was very nice and made sure we understood our options. The nurses also were very nice and took care of us throughout the whole process.”

Vance was given the option of surgery to correct the condition, but he didn’t feel good about traditional surgery for trigeminal neuralgia. So, they chose the other option of CyberKnife radiosurgery treatment. In addition to its extreme precision, CyberKnife treatments are pain free, do not require anesthesia or an external head frame and are performed on an outpatient basis. Patients come to the treatment in their street clothes, listen to their favorite CD and are able to return to normal activities immediately following treatment.

“Trigeminal neuralgia (tic doulouroux) treatment with radiation requires the highest single dose of radiation used in our specialty to a nerve right next to the brainstem,” Dr. Bertoli explains. “Accuracy is critical as the brainstem is the structure that connects the rest of the brain to the spinal cord. The CyberKnife allows us to treat patients for trigeminal neuralgia with a high (90%) change of pain relief and a low chance of long term side effects.”

Mr. Vance’s one time treatment took place in November 2009, and took less than two hours. Within 2 weeks of his treatment, Vance was completely off his medication.

“All of the nursestook great care of me,” Vance says. “And Dr. Bertoli, well, I owe him a lot.” At his February 2010 follow up, the CyberKnife team found that Vance continued to be 100% pain free as he still reports today. He continues to go about his daily activities without worrying about the trigeminal neuralgia pain returning.