Trigeminal Neuralgia

William Calvin wcalvin at u.washington.edu
Sun Apr 3 13:42:34 EST 1994

odin at gate.net () writes:

>What causes remission with Trigeminal Neuralgia. If remission occurs 
>occasionally is there any scientific knowledge as to why and is there
>any natural method for causing remission? Remission is usually of short 
>duration, not lasting longer than several weeks at a time. Medication is 

Not known.  The primary problem in trigeminal neuralgia (as opposed to 
atypical trigeminal neuralgia) in most cases is an ectatic artery, 
elongated and stiffened by atherosclerosis, that presses on the 
trigeminal fibers near where they enter the brain stem.  For popular 
accounts, see Mark Shelton's book WORKING IN A VERY SMALL PLACE or my 
chapter in THE THROWING MADONNA titled "What to do about tic douloureux."

The most effective treatment is to move the artery off the nerve root and 
insert a little sponge to pad it.  That's major surgery but quite 
successful in thr hands of neurosurgeons who do a lot of it (Peter 
Jannetta at Univ of Pittsburgh is the best known).  The other procedures 
don't attack the "root cause" but rather seek to deaden the pain by 
damaging the nerve elsewhere, places that can be reached more easily (and 
only under local anesthesia).  Again, in good hands, it's pretty 
successful but has side effects in many cases (and, I suspect, is more 
likely to recur).

In short, you should be seeing a neurosurgeon at a major university 
medical center (or one specially trained; I have a friend at Group Health 
in Seattle who does quite a few of these operations quite successfully).

    William H. Calvin   WCalvin at U.Washington.edu
    University of Washington  NJ-15
    Seattle, Washington 98195 FAX:1-206-720-1989

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