Center for Cranial Nerve Disorders

The Center for Cranial Nerve Disorders was established at Allegheny General Hospital in 2000, treating disabling disorders as trigeminal neuralgia, acoustic neuroma, hemifacial spasm, facial nerve disorder, and intractable vertigo.

Dr Peter Jannetta, Vice Chairman, Department of Neurosurgery, Allegheny General Hospital, has been responsible for seminal discoveries in the field of cranial nerve disorders.  His procedure of microvascular decompression is the most effective surgical treatment for trigeminal neuralgia and hemifacial spasm, and is also useful in the treatment of a variety of other disorders stemming from cranial nerve dysfunction.  Dr Jannetta has performed more than 6,000 procedures of a similar nature with an overall success rate that has stood the test of time.

Dr. Jannetta is recognized foremost for his groundbreaking research into the pathology and treatment of cranial nerve compression syndromes, conditions of impairment of one or more of the twelve pairs of cranial nerves involved in, among other things, motor function of the tongue, eyes, and facial muscles.   The most prominent of these syndromes is trigeminal neuralgia (TGN), a condition of chronic debilitating pain of the cheek, lips, gums, or chin on one side of the face.  Identifying the cause of the TGN as compression of the fifth cranial nerve (trigeminal nerve) by surrounding blood vessels, Dr. Jannetta developed a microvascular decompression procedure that now offers patients an effective therapeutic alternative when medications fail.  The long-term effectiveness of the procedure was heralded by the New England Journal of Medicine in 1996. 

Microvascular decompression is a microscopic procedure that involves creating a small opening in the skull behind the ear to examine the trigeminal nerve, reposition any compressive arteries and place a protective pad between the nerve and artery.  If the blood vessel pressing on the nerve is a vein, it may be treated in similar fashion or surgically removed.

Related conditions effectively treated as a result of Jannetta's innovation include hemifacial spasm and glossopharyngeal neuralgia, a disorder of the ninth cranial nerve that interferes with a patient's ability to taste and may cause chronic pain of tongue and throat.

In addition to treating routine cranial nerve disorders, Allegheny General Hospital is exploring the frontier of cranial nerve dysfunction and the possible implications of left-sided cranial nerve and brainstem vascular compression in the genesis of essential hypertension; right-sided cranial nerve and brainstem compression in the genesis of type 2 diabetes; and lower cranial nerve and brainstem compression in the etiology of the sympathetic dysfunction that results in idiopathic cardiomyopathy.  

Our Areas of Focus:

• Face pain (facial neuralgia and other disorders with similar symptoms)
• Trigeminal Neuralgia
• Hemifacial Spasm
• Meniere's Disease 
• Vertigo
• Tinnitus
• Hypertension  (high blood pressure)
• Torticollis and Spasmodic Torticollis

Associated Treatments

Our neurologists offer medical treatment of facial pain disorders including trigeminal neuralgia.  Examples of specific medications that been demonstrated to provide pain relief for trigeminal neuralgia include carbamezepine, phenytoin, and lioresal. 

Microvascular Decompression (MVD) – the surgical exploration with the operating microscope and visualization of the junction where the trigeminal nerve enters the base of the brain, followed by the coagulation or moving and padding away any compressing blood vessels.

Microsurgery – surgery that is performed with the use of an operating microscope by experienced microsurgeons

Stereotactic Radiosurgery – treats brain disorders with a precise delivery of a high dose of radiation.  Focused radiation beams are delivered to a specific area of the brain to treat abnormalities, tumors, or functional disorders.

Associated Physicians/Staff

Physicians

Neurosurgery

• Peter J. Jannetta, MD
• Bennett Blumenkopf, MD
• Ray Sekula, MD

Neuro-otology

• Moises Arriaga, MD
• Douglas Chen, MD
• Todd Hillman, MD

Clinical Support Staff

• Ann Wilkerson, RN
• Ross Graham, PA-C

Research Staff

• Lynn Hollihan, RN
• Michelle Mora

Related Links and Patient Education

• The Trigeminal Neuralgia Association Homepage — extensive information on treatment alternatives, current research, and patient support groups.
• Face Pain Resources — Overview of face pain syndromes, Fact
• Sheets, Frequently Asked Questions, Pain Glossary, Medical Abstracts and Reprints, Gateways to Searchable Resources, compilation of sources for finding a doctor. Over 120 subsidiary pages and 4000 links.
• Facial Neuralgia Resources — Large resource site for information on face pain, with a primary focus on facial neuralgias. Over 200 subsidiary pages, links to treatment information and patient experience reports.
• Surgical Treatment of Trigeminal Neuralgia and Hemi-facial Spasm — Albert L. Rhoton, Jr., MD, University of Florida.
• Trigeminal Neuralgia — You Are Not Alone. — A collection of links and basic data on treatment of Trigeminal Neuralgia from several perspectives.
• Healthlink USA — links to websites for diagnosis, treatment, patient support, etc.
• Meniere's Disease and Dizziness Support Group — a brief description with points ofcontact, provided by the National Organization for Rare Disorders.
• On-Line Support Groups — for Vestibular Disorders, including Meniere's, provided by The Vestibular Disorders Association
  • The Vestibular Disorders Association (VEDA)
  • Meniere's Disease — What You Need to Know —book order form from VEDA
• American Tinnitis Association
• Australian Tinnitus Association
• Action for Tinnitus in the UK, — Advocacy group for expanded research and greater public and professional awareness of the disorder.
• Martha Entenmann Tinnitus Research Center, Inc — non profit organization trying to promote focussed research in particular therapies
• Craniosynostosis and Parents Support
• Neurology Web Forums at Massachusetts General Hospital — over 170 patient-to-patient bulletin-boards for exchange of concerns and information.
• Spasmodic Torticollis Bulletin Board Archive —Doc Shop Mall Health Resources.
• Plagiocephaly.org — Information on the assessment and correction of abnormal head shape.
• Dystonias — fact sheet from the National Institute of Neurological Disorders and Stroke.
• Amazon.com — lists a book titled "Torticollis : Differential Diagnosis, Assessment, and Treatment, Surgical Management and Bracing (for Pediatrics)."