We discuss this with Dr. Francesco, a neurosurgeon at Ars Medica Clinic.

Early Symptoms: Sudden, Unexplained Pain

Years before her diagnosis, Mrs. R.R. began experiencing sharp, intense pain in the central part of her face, near her upper lip. The attacks felt like electric shocks, occurring while she ate or spoke, forcing her to stop abruptly.

The pain struck multiple times a day, unpredictably, leaving her face contorted in discomfort. As often happens, the first suspicion was a dental issue. She consulted a dentist, who treated and eventually extracted a molar. Relief was temporary — lasting only a few days. The painful episodes returned, just as severe as before.

Other attempts, including acupuncture, provided only minimal and short-lived benefit.

When Pain Interferes with Daily Life

Over time, the situation worsened. During conversations, she would suddenly stop, holding her cheek in pain. Some family members even doubted whether the problem was purely physical.

Finally, a neurologist visit clarified the cause: trigeminal neuralgia, a disorder of the trigeminal nerve responsible for facial sensation. She was prescribed a targeted pharmacological therapy, which initially worked very well. The pain almost completely subsided, giving her some relief and peace of mind.

Medication Becomes Less Effective, Side Effects Increase

Unfortunately, after a few months, the pain returned. Doses had to be gradually increased to control the episodes, but at the cost of significant side effects: confusion, drowsiness, and a sense of instability.

For years, Mrs. R.R. lived with cycles of improvement and sudden flare-ups, often triggered by cold or fatigue. Eventually, the pain worsened dramatically: it became constant, more widespread, and began to involve the eye area. Medications no longer worked, and blood tests began showing signs of liver stress.

At that point, consulting a neurosurgeon became inevitable.

Choosing Surgery Despite Advanced Age

The idea of surgery was daunting, especially since Mrs. R.R. had never undergone an operation before. She also feared losing facial sensation. After several consultations, however, she learned about a minimally invasive procedure performed under local anesthesia, targeting only the nerve responsible for her pain.

Given the complete ineffectiveness of medications, she decided to proceed with the intervention.

A Quick, Effective Procedure

The surgery took place in April. A very fine needle was guided to the Gasserian ganglion, a structure at the base of the trigeminal nerve. The patient remained awake under local anesthesia, and meticulous care was taken to preserve facial sensation.

The outcome was remarkable: the day after surgery, Mrs. R.R. was discharged pain-free and without residual discomfort. She could finally eat and speak without fear.

Returning to Normal Life

Over time, Mrs. R.R. confirmed that the pain has not returned. She resumed her daily life immediately and no longer takes any medication. Her daughter recalls a charming anecdote: at the end of the procedure, her mother asked in surprise if the operation was about to start, not realizing it had already been completed.

This story demonstrates that, even in advanced age, a correct diagnosis and appropriate treatment can restore a pain-free, fully functional life.