Trigeminal Neuralgia

FDAKER at VM.TEMPLE.EDU FDAKER at VM.TEMPLE.EDU
Thu Oct 6 14:07:07 EST 1994


In article <evanoffm.1.007E7ECB at access.mountain.net>
 
evanoffm at access.mountain.net (Mike Evanoff) writes:
 
>
>I am seeking information on correcting the problem of Trigeminal Neuralgia for
>my mother, she is 50 years old.  She is taking tegratol, but this doesn't seem
>to be helping.
 
Trigeminal neuralgia (tn) can be treated conservatively at first and often
successfully with drugs such as tegretol as you mentioned or can be combined
with other tn drugs such as baclofen.  Also I've read about oxcarbazepine
which may not be available yet but is to have reduced incidence of side effects
A minor invasive procedure beyond drug therapy is retrogasserian percutaneous
rhizotomy.  A needle is placed through the skin to approach nerve tissue inside
the skull (cranial nerve V or trigeminal) in order to selectively destroy
abnormal tissue by way of heat (radiofrequency rhiz.) or glycerol (neurolytic
rhizotomy).  Rhizotomies are repeatable but some uncomfortable and are often
reserved for patients 65+ or those who are in poor health and could not tolerat
more aggressive invasive surgery.  Your mother being 50 may be suitable for
the latter surgery.  This is known as microvascular decompression surgery in
which the skull is opened to approach the trigeminal nerve in order to
relieve pressure being placed by an artery (or vein).  There is reportedly
an 80-90% success rate in relieving tn pain initially but there is some debate
as to the long term relief although generally it is quite good.   A main center
in the  US is Presbyterian Hosp., Univ of Pittsburgh Sch of Medicine.  Dr.
Peter Janetta has perfected this procedure and is a specialists in tn.  I assum
e your mother has had a battery of tests to rule out the chance of a tumor,
aneurysm, or multiple sclerosis since these are potential cause of tn.  If not,
she should.  Best of luck to your mother.
 
David Aker, Ph.D.
Temple Unvi. Sch of Medicine
Dept of Anat and Cell Biology  fdaker at vm.temple.edu



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