A group of Edmonton researchers is recruiting dozens of patients across the province to take part in a new clinical trial aimed at helping those suffering from trigeminal neuralgia, historically dubbed the “suicide disease” because of the severe impact it has on patients.

The term dates back to a time before effective treatments were available, when an estimated quarter of patients died by suicide due to the severity of the pain.

“Trigeminal neuralgia is one of the most severe pains known to mankind,” said Dr. Tejas Sankar, a neurosurgeon at the University of Alberta Hospital.

The condition causes excruciating, stabbing facial pain. In the past, treatment was nerve pain medication.

However, doctors say the side effects and effectiveness of medications caused issues for many patients. Another invasive surgery called microvascular decompression can also be used. Gamma Knife radiation was used as a last resort.

Researchers are hoping to flip the switch, using the non-invasive surgery as a first resort.

“We treat trigeminal neuralgia by giving a pretty high dose of radiation to the trigeminal nerve on the affected side, but the longer you wait before you offer Gamma Knife, the less likely it is to lead to long-term remission of the disease,” Dr. Sankar said.

“What if you could break that cycle much, much earlier… soon after the diagnosis?” 

Dr. Sankar said his team’s research, using MRI, shows that living with the condition actually impacts the way the brain works.

There are around 700 new cases of trigeminal neuralgia diagnosed in Alberta every year. The goal of the trial is to stop the changes in the brain, before they become permanent.

“The longer you have this facial pain condition, the more lasting changes occur in the brain both structurally and functionally,” Sankar said.

Researchers are looking to recruit 80 patients from across Alberta to take part in the trial at the Scott and Brown Families Gamma Knife Centre at the University of Alberta Hospital — the only facility of its kind in the province.

Half of the patients will receive standard nerve pain medications, while the other half will undergo what researchers call “ultra‑early” Gamma Knife surgery.

Researchers say the control group will receive today’s standard treatment and can still opt for Gamma Knife later, if needed

Dr. Sankar’s team will follow patients for five years, evaluating their pain using the international standard Barrow Neurological Institute Facial Pain Scale.

“We know from before that patients who are treated with Gamma Knife, even later in the disease, the ones who are success stories are real success stories,” he told Global News. “They’re pain-free, their quality of life is phenomenal, and they’re off medications.”

That includes patients like Norm Sanche, who was diagnosed with the condition four years ago. Sanche told Global News that before he underwent Gamma Knife surgery, he would suffer sometimes up to three times a day with pain.

“It’s like 110 volts to your head. It’s not fun,” he said. “It was one of those things that is in the back of your mind. It’s kind of scary because you never know when it’s going to go off.”

He underwent the procedure in April 2025 and said after weaning off the medication, he now lives a normal, pain-free life.

“It’s a life-changer,” he said. “Within a month, I was on a golf course!”

The goal is for the Gamma Knife surgery to damage the nerve enough to interrupt the pain signals being sent between the face and the brain. By inducing subtle damage, surgeons aim to stop excessive “cross‑talk” within the nerve that allows pain signals to over‑fire, while not damaging important nerves that control things like sensation in the face and chewing.

“It’s not as rare as you might think,” Dr. Sankar said about the condition.

“One of the issues is that, because it’s not well known, many people go quite some time before they get a diagnosis.”

Dr. Sankar said most of the time people end up going to their dentist because the pain is in the jaw and the cheek, but that takes time.

“By that point, several months have passed and we’re sort of fighting the clock because that chronic pain is going to become stamped into the brain,” he said.

“We hope that one of the benefits of this trial is not just a better way to treat trigeminal neuralgia by hitting it early with Gamma Knife but also increasing awareness of the disease so that people can come in shortly after they develop the symptoms.”

The Gamma Knife uses highly-focused beams of radiation to treat brain conditions. The one at the University of Alberta Hospital was brought in 2017. It is the only one west of Winnipeg in Canada and allows doctors to do highly-specialized procedures, without a scalpel.

“Access to it has really changed the game,” Dr. Sankar said. “Not just for the treatment of trigeminal neuralgia, but also the treatment of many other conditions, you know, brain tumours and brain cancers, other conditions as well, blood vessel abnormalities.”

If early Gamma Knife surgery prevents chronic pain from becoming permanent, Dr. Sankar hopes it could become first‑line treatment, sparing patients’ years of medication side effects and treatment failure.

For patients like Sanche, the potential of earlier intervention is already clear.

“If I can help somebody else out, it’s a win-win,” he said.

Recruitment for the study is ongoing, with patients being followed for up to five years to determine whether early Gamma Knife surgery can prevent chronic pain from becoming permanent.

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