|
| Trigeminal Neuralgia |
| |
The first line of treatment for TN is usually with one of a group of medications called "anti-seizure medications". Often patients are started on a very low dose which is increased to the lowest effective dose. It can take several weeks before it can be determined if a particular drug is effective. Some of these medications require periodic monitoring of the blood to avoid undesirable side-effects. There are several different medications available so that inadequate responses or side-effects from one medication can lead to trials of other drugs.
When medication is ineffective, surgery or special injections (blocks) may be recommended. Surgery is generally performed by a neurosurgeon while blocks are performed by specially trained anesthesiologists. The injections are aimed at temporarily or permanently blocking the effected branch of the trigeminal nerve. Patients should exercise caution before undergoing these procedures because permanent numbness and continued pain can occur.
One surgical treatment, called microvascular decompression ("MVD"), is designed to take the pressure off the trigeminal nerve by placing a small cushion between it and a blood vessel.
There are four other blocking procedures that treat the nerve in order to interrupt the pain. Three of these procedures are done through-the-cheek. They are: Balloon Compression, Glycerol Injection, and Radiofrequency Lesioning. A relatively new procedure is Radiosurgery (Gamma Knife), which uses highly focused beams of radiation to treat the nerve.
Of course, if the neuralgia-like pain is from the pressure of a tumor, this will likely be treated by surgery, radiation therapy and/or other forms of treatment appropriate for the particular pathology.
As with treatment for any disorder, the patient should have a frank discussion of the risks and benefits of the chosen treatment as well as treatment alternatives. It is always advisable to seek a second opinion.
|
| |
|
| |
|
|
