{"id":79,"date":"2026-04-30T11:26:49","date_gmt":"2026-04-30T11:26:49","guid":{"rendered":"https:\/\/blog.drjaydev.com\/?p=79"},"modified":"2026-10-26T12:49:09","modified_gmt":"2026-10-26T07:19:09","slug":"inferno-on-the-face-trigeminal-neuralgia","status":"publish","type":"post","link":"https:\/\/blog.drjaydev.com\/index.php\/2026\/04\/30\/inferno-on-the-face-trigeminal-neuralgia\/","title":{"rendered":"Inferno on the Face"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"79\" class=\"elementor elementor-79\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-19f0519 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"19f0519\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f328992\" data-id=\"f328992\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a97f8c2 elementor-widget elementor-widget-heading\" data-id=\"a97f8c2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Inferno on the Face<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8c19632 elementor-widget elementor-widget-text-editor\" data-id=\"8c19632\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A neurosurgeon&#8217;s account of trigeminal neuralgia \u2014 the pain that has no mercy \u2014 and the surgery that can silences it permanently<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c3602c elementor-align-center elementor-widget elementor-widget-post-info\" data-id=\"3c3602c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"post-info.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-inline-items elementor-icon-list-items elementor-post-info\">\r\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-c4bff4b elementor-inline-item\" itemprop=\"author\">\r\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\r\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-user-circle\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 104c-53 0-96 43-96 96s43 96 96 96 96-43 96-96-43-96-96-96zm0 144c-26.5 0-48-21.5-48-48s21.5-48 48-48 48 21.5 48 48-21.5 48-48 48zm0-240C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zm0 448c-49.7 0-95.1-18.3-130.1-48.4 14.9-23 40.4-38.6 69.6-39.5 20.8 6.4 40.6 9.6 60.5 9.6s39.7-3.1 60.5-9.6c29.2 1 54.7 16.5 69.6 39.5-35 30.1-80.4 48.4-130.1 48.4zm162.7-84.1c-24.4-31.4-62.1-51.9-105.1-51.9-10.2 0-26 9.6-57.6 9.6-31.5 0-47.4-9.6-57.6-9.6-42.9 0-80.6 20.5-105.1 51.9C61.9 339.2 48 299.2 48 256c0-110.3 89.7-200 200-200s200 89.7 200 200c0 43.2-13.9 83.2-37.3 115.9z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-author\">\r\n\t\t\t\t\t\t\t\t\t\tDr. Jaydev Panchawagh\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t<\/li>\r\n\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-89ea835 elementor-inline-item\" itemprop=\"datePublished\">\r\n\t\t\t\t\t\t<a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/04\/30\/\">\r\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\r\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-calendar\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12 192h424c6.6 0 12 5.4 12 12v260c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V204c0-6.6 5.4-12 12-12zm436-44v-36c0-26.5-21.5-48-48-48h-48V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H160V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H48C21.5 64 0 85.5 0 112v36c0 6.6 5.4 12 12 12h424c6.6 0 12-5.4 12-12z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-date\">\r\n\t\t\t\t\t\t\t\t\t\t<time>April 30, 2026<\/time>\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t\t<\/a>\r\n\t\t\t\t<\/li>\r\n\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-cec31a0 elementor-inline-item\">\r\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\r\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-clock\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8zm0 448c-110.5 0-200-89.5-200-200S145.5 56 256 56s200 89.5 200 200-89.5 200-200 200zm61.8-104.4l-84.9-61.7c-3.1-2.3-4.9-5.9-4.9-9.7V116c0-6.6 5.4-12 12-12h32c6.6 0 12 5.4 12 12v141.7l66.8 48.6c5.4 3.9 6.5 11.4 2.6 16.8L334.6 349c-3.9 5.3-11.4 6.5-16.8 2.6z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-time\">\r\n\t\t\t\t\t\t\t\t\t\t<time>11:26 am<\/time>\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t\t<\/li>\r\n\t\t\t\t<\/ul>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-08349a5 elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"08349a5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" fill=\"#000000\" width=\"800px\" height=\"800px\" viewBox=\"0 0 56 56\"><path d=\"M 27.9883 52 C 29.2774 52 29.9336 51.1328 31.2461 49.3516 L 45.2383 30.6719 C 45.8711 29.8047 46.2461 28.9375 46.2461 28 C 46.2461 27.0390 45.8711 26.1953 45.2383 25.3281 L 31.2461 6.6250 C 29.9336 4.8672 29.2774 4.0000 27.9883 4.0000 C 26.7227 4.0000 26.0664 4.8672 24.7539 6.6250 L 10.7617 25.3281 C 10.1289 26.1953 9.7539 27.0390 9.7539 28 C 9.7539 28.9375 10.1289 29.8047 10.7617 30.6719 L 24.7539 49.3516 C 26.0664 51.1328 26.7227 52 27.9883 52 Z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0f054c2 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"0f054c2\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-96644f5\" data-id=\"96644f5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c53c497 elementor-widget elementor-widget-text-editor\" data-id=\"c53c497\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>&#8220;Many neurologists consider it among the most severe pains the human nervous system can generate.<br \/>Some have called it the suicide disease \u2014 not as metaphor,<br \/>but because untreated cases carry a real risk of pushing patients toward self-harm.&#8221;<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c046fcf elementor-widget elementor-widget-text-editor\" data-id=\"c046fcf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2014 Dr Jaydev Panchawagh \u00b7 Trigeminal Neuralgia Centre, Pune<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a6f4fd8 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"a6f4fd8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3900727\" data-id=\"3900727\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7d7dd40 elementor-widget elementor-widget-text-editor\" data-id=\"7d7dd40\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div dir=\"auto\">\n<p><strong><span style=\"; font-size: 5rem; font-weight: bold; float: left; margin-right: 8px; line-height: .8; color: #752240; font-family: 'Cormorant Garamond', serif;\">W<\/span><\/strong><br>hile operating on a patient with the extreme pain of <a href=\"https:\/\/drjaydev.com\/trigeminal-neuralgia\">trigeminal neuralgia<\/a>, I turned the beam of the neuromicroscope deep into the lower part of the brain \u2014 onto the very structure called the pons. Under that cold, brilliant light, the trigeminal nerve came into view. The fifth cranial nerve. The great sensory highway of the face.<\/p>\n<p>Her trigeminal nerve was not the smooth, pearl-white cord it was supposed to be. It had been crushed flat. A blood vessel \u2014 large, unyielding, pulsing \u2014 had buried itself into the nerve\u2019s most vulnerable segment: the root entry zone, where the protective myelin sheath is thinnest. The vessel had not merely rested against the nerve. Over the years, it had bored into it, and the nerve had frayed apart in response \u2014 its fibres separating like threads pulled from a torn cloth.<\/p>\n<p><em>Seventy-five to eighty times a minute, the artery pulsed. With each beat, a blow of a hammer on the nerve. For years. Day after day, month after month, year after year. The nerve looked like a crushed ribbon.<\/em><\/p>\n<p>\u201cThis degree of damage need not have happened. If surgery had been performed earlier, this patient would not have suffered so long.\u201d<\/p>\n<p>The delay, in case after case, has the same cause: the patient simply did not know. The family did not know. Often enough, even the treating doctors did not know. Trigeminal neuralgia has spent too long entangled in a web of misunderstanding.<\/p>\n<h2>Nivedita Bhatnagar: An Architect Without Words<\/h2>\n<p>Nivedita Bhatnagar (name changed) \u2014 an architect from Delhi. Deeply capable. Perceptive. And extraordinarily eloquent about her own pain. When she first came to our centre, she could only gesture. Even the small act of opening her mouth to form words triggered a bolt of electricity through the right side of her face. The simple daily architecture of language had become a minefield.<\/p>\n<p>\u201cIt truly began in January 2004. A sudden, sharp pain would start in the upper right gum and radiate into the right cheek. The pain was like an electric shock. Instant. Without warning. Brushing my teeth, if the brush touched the right gum \u2014 or while chewing on that side \u2014 these were enough to trigger it. An unbearable, shattering jolt.\u201d<\/p>\n<p>She went first to a dentist, as almost every patient with this condition does. The upper right molar received a root canal. The pain not only persisted \u2014 it grew. A neurologist recognised a nerve problem and prescribed carbamazepine.<\/p>\n<p>\u201cThe medicine helped while it worked. But it made me drowsy. I began forgetting things. As the dose increased, I started losing my balance when I walked. I thought: if one nerve in one small location is the problem, why am I numbing every nerve in my body? That is not treatment. That is suppression.\u201d<\/p>\n<p>She was exactly right. The drugs do not address the cause. They address the signal. And as the underlying compression worsens, the signal grows louder, the dose must rise, and the side effects multiply. The person diminishes.<\/p>\n<h2>The Architecture of Fear<\/h2>\n<p>It is not the pain alone that destroys a life \u2014 it is the anticipation of pain. Between attacks, the person lives in a state of suspended dread. Will it happen now? This question follows every meal, every conversation, every walk in the wind. The face becomes a danger zone. People stop speaking in full sentences, stop eating certain foods, stop going outside in cold weather, stop socialising.<\/p>\n<p>Sustained pain remaps the brain. It alters threat perception, attention, sleep, and mood. A person with long-standing trigeminal neuralgia has not only a damaged nerve \u2014 they have a nervous system that has been reorganised by years of crisis.<\/p>\n<h2>What Is Trigeminal Neuralgia \u2014 The Science<\/h2>\n<p>The trigeminal nerve is the fifth and largest of the twelve cranial nerves, with three branches covering the forehead and eye, the cheek and upper jaw, and the lower jaw and chin. In trigeminal neuralgia, something goes wrong at precisely the point where the nerve enters the pons. An adjacent blood vessel \u2014 most often the superior cerebellar artery \u2014 subjects the nerve to constant mechanical pressure.<\/p>\n<p>As we age, arteries lengthen and grow more tortuous. A vessel that once ran parallel to the nerve begins to loop toward it. It makes contact. It presses. It pulses \u2014 seventy, eighty, a hundred times a minute. Over years, this pulsatile trauma erodes the myelin sheath. When the myelin is gone, bare axons are exposed. The trigeminal nerve begins to misfire in response to the lightest stimuli: a brushstroke, a breath of cool air, a sip of water.<\/p>\n<p>\u201cSome have called it the suicide disease \u2014 not as metaphor, but because untreated cases carry a real risk of pushing patients toward self-harm. The pain is that severe and that relentless.\u201d<\/p>\n<h2>The Inadequacy of Burning the Nerve<\/h2>\n<p>For most of the last century, treatments have been aimed at the nerve itself \u2014 not the offending vessel. Alcohol injections. Radiofrequency ablation. Glycerol injections. Stereotactic radiosurgery. But this logic misses the point entirely. The nerve is not malfunctioning because it is inherently defective. It is malfunctioning because it is being compressed.<\/p>\n<p>Ablating the nerve addresses the symptom while leaving the cause in place. As the vessel continues to press, the disease continues to advance. Each repetition carries risks \u2014 including permanent facial numbness, or the development of anesthesia dolorosa, in which the face is numb but burning simultaneously.<\/p>\n<h2>Peter Jannetta and the Surgery That Changes Everything<\/h2>\n<p>In the 1960s, an American neurosurgeon named Peter Jannetta changed the course of this disease permanently. His premise was elegant in its simplicity: if the problem is a blood vessel compressing a nerve, the solution is to separate them.<\/p>\n<p>A small opening is made in the skull behind the ear. The neuromicroscope floods the dark, crowded space of the posterior fossa with light. The surgical team navigates until the trigeminal root and its offending vessel come into view. Then, with instruments no wider than a matchstick, the vessel is carefully lifted away from the nerve. A small pad of Teflon felt is placed between them. The nerve, freed from pressure, is left entirely intact.<\/p>\n<h3>What the Published Results Show: Complete Pain Relief in 70\u201390% of Patients<\/h3>\n<p>Not reduced pain. Absent pain. Patients who have been unable to speak, eat, or feel wind on their face for years awaken from surgery able to do all of these things.<\/p>\n<p>\u201cAfter surgery, the pain was gone. Completely gone. The fear was gone. The medications were stopped. I had forgotten what it was like to simply eat a meal, or speak freely, or feel wind on my face.\u201d<\/p>\n<p>\u201cAnd I was sad. Not for myself \u2014 I was free of it. I was sad because I had not found this sooner. Seven years. Seven years of suffering that did not have to happen.\u201d<\/p>\n<h2>The Gap That Must Be Closed<\/h2>\n<p>Seven years. For want of information. Trigeminal neuralgia affects roughly one in ten thousand people \u2014 which means, in a country of over a billion, tens of thousands are living with it at any given moment. What is missing is not the knowledge. The knowledge exists. What is missing is the bridge between the knowledge and the patient.<\/p>\n<p><em>The general practitioner who recognises the lightning-bolt description and refers promptly. The neurologist who knows that <a href=\"https:\/\/drjaydev.com\/mvd-surgery\">MVD<\/a> exists and spares the nerve. The family member who searches and finds the right centre. Each of these links in the chain saves years of suffering.<\/em><\/p>\n<h2>A Note on This Writing \u2014 Gudi Padwa<\/h2>\n<p>I first wrote about this on Gudi Padwa \u2014 the Marathi New Year, a day of beginnings and renewed resolve. The gudi is a decorated staff erected each year as a banner of victory, a symbol of rising above adversity. Peter Jannetta raised such a banner in the operating rooms of Pittsburgh in the 1960s.<\/p>\n<p><em>If someone you know lives with lightning pain in one side of the face \u2014 pain triggered by the lightest touch, by food, by cold air, by the simple act of speaking \u2014 know this: there is a cause. The cause can be found. And in most cases, it can be corrected. The face need not remain a burning inferno.<\/em><\/p>\n<p>The author is a neurosurgeon based in Pune, with a specialised focus on Microvascular Decompression for trigeminal neuralgia and hemifacial spasm since 2004.<\/p>\n<p><strong>Dr Jaydev Panchawagh&nbsp; \u00b7&nbsp; Trigeminal Neuralgia Centre&nbsp; \u00b7&nbsp; Pune, India<\/strong><\/p>\n<p>#TrigeminalNeuralgia&nbsp; \u00b7&nbsp; #MVD&nbsp; \u00b7&nbsp; #FacePain&nbsp; \u00b7&nbsp; #Neurosurgery&nbsp; \u00b7&nbsp; #PeterJannetta&nbsp; \u00b7&nbsp; #DrJaydevPanchawagh<\/p>\n<p><strong>&nbsp;<\/strong><\/p>\n<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c37ea98 elementor-widget elementor-widget-text-editor\" data-id=\"c37ea98\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"body-para\"><i>Names and identifying details have been changed to protect patient privacy. 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elementor-element elementor-element-355d202\" data-id=\"355d202\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3707d50 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"3707d50\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_parent&quot;:&quot;yes&quot;,&quot;sticky_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;],&quot;sticky_offset&quot;:0,&quot;sticky_effects_offset&quot;:0,&quot;sticky_anchor_link_offset&quot;:0}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-00bda9e\" data-id=\"00bda9e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a9892c4 elementor-widget elementor-widget-heading\" data-id=\"a9892c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">About the Author<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-efae5fa elementor-widget elementor-widget-image\" data-id=\"efae5fa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"933\" src=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/04\/imgg-878x1024.png\" class=\"attachment-large size-large wp-image-35\" alt=\"\" srcset=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/04\/imgg-878x1024.png 878w, https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/04\/imgg-257x300.png 257w, https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/04\/imgg-768x896.png 768w, https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/04\/imgg.png 960w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3cd00b3 elementor-widget elementor-widget-text-editor\" data-id=\"3cd00b3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A neurosurgeon by training, a writer by compulsion \u2014 and a student of the human condition by necessity. These essays explore what science, surgery, literature, and life have in common: the fragile, extraordinary act of paying attention.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6253c37 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"6253c37\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;headings_by_tags&quot;:[&quot;h2&quot;,&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;,&quot;h6&quot;],&quot;marker_view&quot;:&quot;numbers&quot;,&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\r\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\r\n\t\t\t\tTable of Contents\t\t\t<\/h4>\r\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__6253c37\" aria-expanded=\"true\" aria-label=\"Open table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\r\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__6253c37\" aria-expanded=\"true\" aria-label=\"Close table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<div id=\"elementor-toc__6253c37\" class=\"elementor-toc__body\">\r\n\t\t\t<div class=\"elementor-toc__spinner-container\">\r\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-14c9019 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"14c9019\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\r\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"79\"\/>\r\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"14c9019\"\/>\r\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Inferno on the Face - Fine Lines \u2014 Dr. Jaydev Panchawagh&#039;s Neurosurgery Blog\" \/>\r\n\r\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"79\"\/>\r\n\t\t\t\r\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-\">\r\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_99ae400 elementor-col-100\">\r\n\t\t\t\t\t<h6 style=\"color:#F2D060\";>Subscribe To Our Form<\/h6>\n<hr >\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_65e901f elementor-col-100\">\r\n\t\t\t\t\tNew essays, fortnightly. No noise \u2014\nonly ideas worth your time.\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label elementor-screen-only\">\r\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email\" required=\"required\">\r\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\r\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\r\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span 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9.4 9.4 24.6 0 33.9L201.7 409c-9.4 9.4-24.6 9.4-33.9 0l-136-136c-9.5-9.4-9.5-24.6-.1-34z\"><\/path><\/svg><span class=\"elementor-screen-only\">Prev<\/span><\/span><span class=\"elementor-post-navigation__link__prev\"><span class=\"post-navigation__prev--label\">Previous<\/span><span class=\"post-navigation__prev--title\">A Crooked Smile<\/span><\/span><\/a>\t\t\t<\/div>\r\n\t\t\t\t\t\t\t<div class=\"elementor-post-navigation__separator-wrapper\">\r\n\t\t\t\t\t<div class=\"elementor-post-navigation__separator\"><\/div>\r\n\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<div class=\"elementor-post-navigation__next elementor-post-navigation__link\">\r\n\t\t\t\t<a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/05\/02\/eros-in-the-brain\/\" rel=\"next\"><span class=\"elementor-post-navigation__link__next\"><span class=\"post-navigation__next--label\">Next<\/span><span class=\"post-navigation__next--title\">Eros in the Brain<\/span><\/span><span class=\"post-navigation__arrow-wrapper 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id=\"post-items--a400aad\" class=\"row post-items\">\n                    <div class=\"col-lg-6 col-md-6\">\n\n                                    <div class=\"elementskit-post-image-card\">\n                        <div class=\"elementskit-entry-header\">\n                                                            <a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/09\/01\/the-eye-that-winked-without-permission\/\" class=\"elementskit-entry-thumb\">\n                                    <img decoding=\"async\" src=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/09\/The-Eye-That-Winked-Without-Permission.png\" alt=\"The Eye That Winked Without Permission\">\n                                <\/a><!-- .elementskit-entry-thumb END -->\n                                                                                                    <div class=\"elementskit-meta-lists\">\n                                        <div class=\"elementskit-single-meta\"><span class=\"elementskit-meta-wraper\"><strong>01<\/strong>Sep<\/span><\/div>\n                                    <\/div>\n                                                                                            \n                            \n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><!-- .elementskit-entry-header END -->\n\n\t\t\t\t\t\t<div class=\"elementskit-post-body \">\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"entry-title\">\n\t\t\t\t\t<a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/09\/01\/the-eye-that-winked-without-permission\/\">\n\t\t\t\t\t\tThe Eye That Winked Without Permission\t\t\t\t\t<\/a>\n\t\t\t\t<\/h2>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p>In This Essay A Twitch Called Hemifacial Spasm The Surgery Behind It: Microvascular Decompression Recovery After Microvascular Decompression We spend&hellip;<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t                                                            <div class=\"btn-wraper\">\n                                    \n                                                                            <a class=\"elementskit-btn whitespace--normal\" id=\"\" href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/09\/01\/the-eye-that-winked-without-permission\/\">\n                                        \t                                            Read                                        <\/a>\n                                                                    <\/div>\n                                                    <\/div><!-- .elementskit-post-body END -->\n                    <\/div>\n                \n            <\/div>\n                    <div class=\"col-lg-6 col-md-6\">\n\n                                    <div class=\"elementskit-post-image-card\">\n                        <div class=\"elementskit-entry-header\">\n                                                            <a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/08\/04\/the-mathematician-who-diagnosed-himself\/\" class=\"elementskit-entry-thumb\">\n                                    <img decoding=\"async\" src=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/08\/tnhead.webp\" alt=\"The Mathematician Who Diagnosed Himself\">\n                                <\/a><!-- .elementskit-entry-thumb END -->\n                                                                                                    <div class=\"elementskit-meta-lists\">\n                                        <div class=\"elementskit-single-meta\"><span class=\"elementskit-meta-wraper\"><strong>04<\/strong>Aug<\/span><\/div>\n                                    <\/div>\n                                                                                            \n                            \n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><!-- .elementskit-entry-header END -->\n\n\t\t\t\t\t\t<div class=\"elementskit-post-body \">\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"entry-title\">\n\t\t\t\t\t<a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/08\/04\/the-mathematician-who-diagnosed-himself\/\">\n\t\t\t\t\t\tThe Mathematician Who Diagnosed Himself\t\t\t\t\t<\/a>\n\t\t\t\t<\/h2>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p>In this piece Diagnosing Trigeminal Neuralgia: A Patient Who Noticed What Doctors Missed Living With Trigeminal Neuralgia: Four Years Before&hellip;<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t                                                            <div class=\"btn-wraper\">\n                                    \n                                                                            <a class=\"elementskit-btn whitespace--normal\" id=\"\" href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/08\/04\/the-mathematician-who-diagnosed-himself\/\">\n                                        \t                                            Read                                        <\/a>\n                                                                    <\/div>\n                                                    <\/div><!-- .elementskit-post-body END -->\n                    <\/div>\n                \n            <\/div>\n                    <div class=\"col-lg-6 col-md-6\">\n\n                                    <div class=\"elementskit-post-image-card\">\n                        <div class=\"elementskit-entry-header\">\n                                                            <a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/07\/31\/the-body-speaks-first\/\" class=\"elementskit-entry-thumb\">\n                                    <img decoding=\"async\" src=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/07\/The-Body-Speaks-first.webp\" alt=\"The Body Speaks First\">\n                                <\/a><!-- .elementskit-entry-thumb END -->\n                                                                                                    <div class=\"elementskit-meta-lists\">\n                                        <div class=\"elementskit-single-meta\"><span class=\"elementskit-meta-wraper\"><strong>31<\/strong>Jul<\/span><\/div>\n                                    <\/div>\n                                                                                            \n                            \n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><!-- .elementskit-entry-header END -->\n\n\t\t\t\t\t\t<div class=\"elementskit-post-body \">\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"entry-title\">\n\t\t\t\t\t<a href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/07\/31\/the-body-speaks-first\/\">\n\t\t\t\t\t\tThe Body Speaks First\t\t\t\t\t<\/a>\n\t\t\t\t<\/h2>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p>I have spent much of my working life looking directly at the brain. Under the microscope it does not look&hellip;<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t                                                            <div class=\"btn-wraper\">\n                                    \n                                                                            <a class=\"elementskit-btn whitespace--normal\" id=\"\" href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/07\/31\/the-body-speaks-first\/\">\n                                        \t                                            Read                                        <\/a>\n                                                                    <\/div>\n                                                    <\/div><!-- .elementskit-post-body END -->\n                    <\/div>\n                \n            <\/div>\n                <\/div>\n       <\/div>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>A neurosurgeon&#8217;s account of trigeminal neuralgia \u2014 the pain that has no mercy \u2014 and the surgery that can silences it permanently &#8220;Many neurologists consider it among the most severe pains the human nervous system can generate.Some have called it the suicide disease \u2014 not as metaphor,but because untreated cases carry a real risk of pushing patients toward self-harm.&#8221; \u2014 Dr Jaydev Panchawagh \u00b7 Trigeminal Neuralgia Centre, Pune While operating on a patient with the extreme pain of trigeminal neuralgia, I turned the beam of the neuromicroscope deep into the lower part of the brain \u2014 onto the very structure called the pons. Under that cold, brilliant light, the trigeminal nerve came into view. The fifth cranial nerve. The great sensory highway of the face. Her trigeminal nerve was not the smooth, pearl-white cord it was supposed to be. It had been crushed flat. A blood vessel \u2014 large, unyielding, pulsing \u2014 had buried itself into the nerve\u2019s most vulnerable segment: the root entry zone, where the protective myelin sheath is thinnest. The vessel had not merely rested against the nerve. Over the years, it had bored into it, and the nerve had frayed apart in response \u2014 its fibres separating like threads pulled from a torn cloth. Seventy-five to eighty times a minute, the artery pulsed. With each beat, a blow of a hammer on the nerve. For years. Day after day, month after month, year after year. The nerve looked like a crushed ribbon. \u201cThis degree of damage need not have happened. If surgery had been performed earlier, this patient would not have suffered so long.\u201d The delay, in case after case, has the same cause: the patient simply did not know. The family did not know. Often enough, even the treating doctors did not know. Trigeminal neuralgia has spent too long entangled in a web of misunderstanding. Nivedita Bhatnagar: An Architect Without Words Nivedita Bhatnagar (name changed) \u2014 an architect from Delhi. Deeply capable. Perceptive. And extraordinarily eloquent about her own pain. When she first came to our centre, she could only gesture. Even the small act of opening her mouth to form words triggered a bolt of electricity through the right side of her face. The simple daily architecture of language had become a minefield. \u201cIt truly began in January 2004. A sudden, sharp pain would start in the upper right gum and radiate into the right cheek. The pain was like an electric shock. Instant. Without warning. Brushing my teeth, if the brush touched the right gum \u2014 or while chewing on that side \u2014 these were enough to trigger it. An unbearable, shattering jolt.\u201d She went first to a dentist, as almost every patient with this condition does. The upper right molar received a root canal. The pain not only persisted \u2014 it grew. A neurologist recognised a nerve problem and prescribed carbamazepine. \u201cThe medicine helped while it worked. But it made me drowsy. I began forgetting things. As the dose increased, I started losing my balance when I walked. I thought: if one nerve in one small location is the problem, why am I numbing every nerve in my body? That is not treatment. That is suppression.\u201d She was exactly right. The drugs do not address the cause. They address the signal. And as the underlying compression worsens, the signal grows louder, the dose must rise, and the side effects multiply. The person diminishes. The Architecture of Fear It is not the pain alone that destroys a life \u2014 it is the anticipation of pain. Between attacks, the person lives in a state of suspended dread. Will it happen now? This question follows every meal, every conversation, every walk in the wind. The face becomes a danger zone. People stop speaking in full sentences, stop eating certain foods, stop going outside in cold weather, stop socialising. Sustained pain remaps the brain. It alters threat perception, attention, sleep, and mood. A person with long-standing trigeminal neuralgia has not only a damaged nerve \u2014 they have a nervous system that has been reorganised by years of crisis. What Is Trigeminal Neuralgia \u2014 The Science The trigeminal nerve is the fifth and largest of the twelve cranial nerves, with three branches covering the forehead and eye, the cheek and upper jaw, and the lower jaw and chin. In trigeminal neuralgia, something goes wrong at precisely the point where the nerve enters the pons. An adjacent blood vessel \u2014 most often the superior cerebellar artery \u2014 subjects the nerve to constant mechanical pressure. As we age, arteries lengthen and grow more tortuous. A vessel that once ran parallel to the nerve begins to loop toward it. It makes contact. It presses. It pulses \u2014 seventy, eighty, a hundred times a minute. Over years, this pulsatile trauma erodes the myelin sheath. When the myelin is gone, bare axons are exposed. The trigeminal nerve begins to misfire in response to the lightest stimuli: a brushstroke, a breath of cool air, a sip of water. \u201cSome have called it the suicide disease \u2014 not as metaphor, but because untreated cases carry a real risk of pushing patients toward self-harm. The pain is that severe and that relentless.\u201d The Inadequacy of Burning the Nerve For most of the last century, treatments have been aimed at the nerve itself \u2014 not the offending vessel. Alcohol injections. Radiofrequency ablation. Glycerol injections. Stereotactic radiosurgery. But this logic misses the point entirely. The nerve is not malfunctioning because it is inherently defective. It is malfunctioning because it is being compressed. Ablating the nerve addresses the symptom while leaving the cause in place. As the vessel continues to press, the disease continues to advance. Each repetition carries risks \u2014 including permanent facial numbness, or the development of anesthesia dolorosa, in which the face is numb but burning simultaneously. Peter Jannetta and the Surgery That Changes Everything In the 1960s, an American neurosurgeon named Peter Jannetta changed the course of this disease permanently. His premise was<\/p>\n","protected":false},"author":1,"featured_media":711,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-79","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-trigeminal-neuralgia"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.6 (Yoast SEO v27.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Inferno on the Face - Fine Lines \u2014 Dr. Jaydev Panchawagh&#039;s Neurosurgery Blog<\/title>\n<meta name=\"description\" content=\"Inferno on the Face Fine Lines \u2014 Dr. Jaydev Panchawagh&#039;s Neurosurgery Blog Trigeminal Neuralgia\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/04\/30\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Inferno on the Face\" \/>\n<meta property=\"og:description\" content=\"Inferno on the Face Fine Lines \u2014 Dr. Jaydev Panchawagh&#039;s Neurosurgery Blog Trigeminal Neuralgia\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blog.drjaydev.com\/index.php\/2026\/04\/30\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\/\" \/>\n<meta property=\"og:site_name\" content=\"Fine Lines \u2014 Dr. Jaydev Panchawagh&#039;s Neurosurgery Blog\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-30T11:26:49+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-10-26T07:19:09+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blog.drjaydev.com\/wp-content\/uploads\/2026\/05\/2-1.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1920\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Dr. Jaydev Panchawagh\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dr. Jaydev Panchawagh\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":[\"Article\",\"BlogPosting\"],\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia\\\/\"},\"author\":{\"name\":\"Dr. Jaydev Panchawagh\",\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/#\\\/schema\\\/person\\\/421d86d8c7b55f11acc42be8429a69a7\"},\"headline\":\"Inferno on the Face\",\"datePublished\":\"2026-04-30T11:26:49+00:00\",\"dateModified\":\"2026-10-26T07:19:09+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia\\\/\"},\"wordCount\":1617,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/#\\\/schema\\\/person\\\/421d86d8c7b55f11acc42be8429a69a7\"},\"image\":{\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blog.drjaydev.com\\\/wp-content\\\/uploads\\\/2026\\\/05\\\/2-1.webp\",\"articleSection\":[\"Trigeminal Neuralgia\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia\\\/\",\"url\":\"https:\\\/\\\/blog.drjaydev.com\\\/index.php\\\/2026\\\/04\\\/30\\\/inferno-on-the-face-trigeminal-neuralgia-and-the-cure-that-remains-a-secret\\\/\",\"name\":\"Inferno on the Face - 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