The Columbia Trigeminal Neuralgia Center provides comprehensive diagnostic, surgical, and follow-up care for individuals suffering from trigeminal neuralgia. This rare disorder affects individuals of all ages and results in a profoundly diminished quality of life for affected patients. Our mission is to deliver the highest quality evidence-based treatment for individuals with trigeminal neuralgia.
Our Approach to Care
We collaborate with our world-class neuroradiology team to diagnose trigeminal neurology. It all starts with a high-resolution MRI to detect blood vessels, tumors and other structural problems compressing the trigeminal nerve. Once we have a better understanding of the problem, we begin planning your treatment.
The team, in partnership with a world-class neurology team at the Neurologic Institute, participates in innovative drug trials for those patients unsuitable for or unwilling to undergo a surgical option for trigeminal neuralgia.
Effective treatments are available for patients with trigeminal neuralgia:
- Microvascular Decompression Surgery - A surgical procedure that involves a moving a blood vessel away from a nerve and interposing a felt cushion between the blood vessel and the trigeminal nerve through a small incision behind the ear.
- Ablative - A group of procedures that intentionally injures the trigeminal nerve and often result in complete or partial relief of pain. These procedures include injuring the nerve with chemical, mechanical pressure, heat, or radiation.
- Neuromodulatory - A group of procedures that indirectly treat facial pain using technology that alters brain and nerve activity. These techniques include transcortical direct stimulation, deep brain stimulation, spinal cord stimulation, peripheral nerve stimulation, and transcutaneous electrical stimulation.
Dr. Sekula has performed more than 1000 MVDS for trigeminal neuralgia and continually refined the procedure so that most patients will spend just one or two nights only in the hospital without the need for the intensive care unit prior to discharge from the hospital. He has also championed MVD for elderly patients to avoid the inevitable side effects of repeat ablative procedures. He has led the way in developing a variety of techniques that have been adopted by surgeons around the world to improve patient outcomes.
He has also demonstrated that MVD is often effective in individuals who have failed prior Gamma Knife treatment for trigeminal neuralgia. Above all, he and his team have carefully and methodically evaluated patients to determine which surgical procedure is best for her or him.
Because some patients may not be suitable candidates for microvascular decompression surgery, the team at the NI offer other standard and innovative procedures for patients with trigeminal neuralgia. Dr. Sekula has performed an additional 500 ablative procedures (i.e., glycerol, radiofrequency, and balloon rhizolysis of the trigeminal ganglion) for patients with trigeminal neuralgia. Additionally, Dr. Sekula is one of a few investigators in the world actively investigating the genetics of trigeminal neuralgia.
Dr. Christopher Winfree, a leading neurosurgical pain and nerve specialist in the U.S., a former President of the American Association of Neurological Surgeons Pain Section, provides innovative care with neuromodulatory techniques including peripheral nerve stimulation, DREZ, and intrathecal pain pumps for patients with trigeminal neuralgia.
In an effort to develop new therapies for patients with trigeminal neuralgia, the team is conducting research concerning the fundamental mechanisms underlying the development of trigeminal neuralgia and is the first in the United States to have their research for trigeminal neuralgia supported by the National Institutes of Health. Additionally, Dr. Sekula is one of a few investigators in the world actively investigating the genetics of trigeminal neuralgia.
- Calcium Phosphate Cement Cranioplasty Decreases the Rate of Cerebrospinal Fluid Leak and Wound Infection Compared with Titanium Mesh Cranioplasty: Retrospective Study of 672 Patients
- Development and Evaluation of a Preoperative Trigeminal Neuralgia Scoring System to Predict Long-Term Outcome Following Microvascular Decompression
- Mechanisms Underlying the Selective Therapeutic Efficacy of Carbamazepine for Attenuation of Trigeminal Nerve Injury Pain
- Microvascular Decompression after Failed Gamma Knife Surgery for Trigeminal Neuralgia: a Safe and Effective Rescue Therapy?
- The Utility of Calcium Phosphate Cement in Cranioplasty Following Retromastoid Craniectomy for Cranial Neuralgias
- Utility of the Intensive Care Unit in Patients Undergoing Microvascular Decompression: a Multi-Institution Comparative Analysis