Yosef Shemayovich (77) endured nearly a quarter of a century of debilitating facial pain. Despite trying numerous treatments, his condition worsened. However, a simple treatment at Rambam Health Care Campus (Rambam) in Haifa, Israel, quickly resolved his pain, restoring his quality of life.
Also known as Fothergill disease, trigeminal neuralgia is a long-term pain disorder that affects the trigeminal nerve, responsible for facial sensation and motor functions like biting and chewing. The condition affects 1 in 10,000 people, predominantly women and those over 50.
“Patients with trigeminal neuralgia suffer from severe facial pain for unknown reasons, which gradually worsens and primarily affects the middle and lower regions of the face,” explains Dr. Lior Lev-Tov, attending physician in the Department of Neurosurgery at Rambam. “Pain attacks can be triggered by everyday activities such as eating, brushing teeth, or even a breeze.”
For almost 25 years, Yosef Shemayovich suffered from the rare ailment without resolution. Shemayovich describes how his pain became increasingly frequent and debilitating. “It started with occasional pain but worsened over time,” explains Shemayovich. “At its peak, it would paralyze me during meals or phone calls. The pain was unbearable. I tried many medications that didn't help and was offered a complicated surgery that scared me, so I continued to suffer.”
Diagnosing trigeminal neuralgia can be challenging, and many patients suffer for years without proper treatment. “Symptoms can be elusive, and there's a lack of awareness about treatment options. Some patients come to us after living with pain for decades,” says Lev-Tov. “While medications help many, there are other treatments for those who do not respond to drugs.”
Accurate and prompt diagnosis is crucial for effective treatment. Besides medication, and surgery, which separates the trigeminal nerve from blood vessels near the brainstem, there are minimally invasive options, including glycerol injections into the trigeminal nerve nucleus via a thin needle through the cheek (rhizotomy).
Recently, when Shemayovich met Lev-Tov at Rambam for an unrelated issue, the physician noticed his trigeminal neuralgia. “I suggested a simple treatment using a thin needle to burn cells in the pain area,” says Lev-Tov. “This minimally invasive procedure yields good results and can prevent the recurrence of attacks. Surgical options are also effective for resistant cases with a clear vascular conflict.”
Shortly after undergoing treatment at Rambam, Shemayovich experienced a significant transformation. “After so many years, I am pain-free. I don't remember the pain anymore,” he says with a big smile. “It's a drastic change, a gift from above and from Rambam.”
Dr. Lior Lev-Tov.
Photography: Rambam HCC