wcalvin at stein1.u.washington.edu
Sun Dec 26 14:11:47 EST 1993
>I have been taking Tegretol for several months now. At first the effect
>was disorientation and drowsiness. But over time that effect wore off.
>I'm taking it for Trigeminal Neuralgia. They eliminated the attacks,
>although the dull sharp pain would still be there at times---but no 1
>minute attacks, NO tic.
You are, I trust, pain-free most of the time, i.e., no lingering pain
between attacks (If not, ignore all that follows). Re meds, you ought to be
able to get phone advice on adjusting dose, so long as you can handle the
blood tests closer to home.
There are two classes of surgical intervention for trigeminal neuralgia,
if the meds don't work. Might check your library for Mark Shelton's
WORKING IN A VERY SMALL PLACE (1987). The puzzle of understanding
trigeminal neuralgia is discussed in an essay "What to do about tic
douloureux" in my book THE THROWING MADONNA (1983,1991).
The mostly widely available surgical procedure is a percutaneous
procedure where one sticks a needle into the trigeminal nerve, just
inside the skull where the ganglion is, and cooks a little bit of it with
The more elegant treatment appears to get at the cause, which is an
elongated artery that is traumatizing, with every heartbeat, the
trigeminal nerve, right where it enters the brainstem. The surgery
merely moves the artery away. This is major
surgery, but it is getting less so; a friend of mine is now making holes
about the size of a quarter. It's a little riskier, just because of the
general anesthetic risk, but it has an excellent cure rate. Peter
Jannetta at U of Pittsburgh is the pioneer, but there are now dozens of
major neurosurgical centers that can probably do the operation.
William H. Calvin WCalvin at U.Washington.edu
University of Washington NJ-15
Psychiatry & Behavioral Sciences
Seattle, Washington 98195
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