{"id":113,"date":"2024-04-08T11:57:28","date_gmt":"2024-04-08T11:57:28","guid":{"rendered":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/?p=113"},"modified":"2024-04-10T06:47:32","modified_gmt":"2024-04-10T06:47:32","slug":"trigeminal-neuralgia","status":"publish","type":"post","link":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/trigeminal-neuralgia\/","title":{"rendered":"TRIGEMINAL NEURALGIA"},"content":{"rendered":"\n<p>Trigeminal neuralgia is\u00a0 the\u00a0 worst pain known in medicine. It is a facial pain on one side of the face, in one or more division of trigeminal nerve(TN)<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"435\" height=\"400\" src=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/sonal-1.jpg\" alt=\"\" class=\"wp-image-117\" srcset=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/sonal-1.jpg 435w, https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/sonal-1-300x276.jpg 300w\" sizes=\"(max-width: 435px) 100vw, 435px\" \/><\/figure>\n\n\n\n<p>This pain is compared to labour pain and kidney stone pain. It causes severe depression , so it is also called SUICIDE DISEASE<\/p>\n\n\n\n<p><strong>CHARACTERISTICS OF PAIN:<\/strong><\/p>\n\n\n\n<p>This pain is of two types- typical and atypical. Typical pain is electric shock like pain , which comes and goes. Spontaneous or precipitated by drinking eating chewing brushing \u00a0etc. Atypical \u00a0pain is continuous or prolong burning facial sensation.<\/p>\n\n\n\n<p><strong>CAUSES:<\/strong><\/p>\n\n\n\n<p>Following are the common causes of TN:<\/p>\n\n\n\n<ul>\n<li>Abnormal neurovascular contact at the root entry zone of the nerve to the brain<\/li>\n\n\n\n<li>Post herpetic neuralgia<\/li>\n\n\n\n<li>Stroke<\/li>\n\n\n\n<li>Trauma<\/li>\n\n\n\n<li>Multiple sclerosis<\/li>\n<\/ul>\n\n\n\n<p><strong>INVESTIGATIONS<\/strong><\/p>\n\n\n\n<p>MRI Brain with CISS sequence is a must investigation for this pain, to rule out tumor causing pain and to look for neurovascular contact, which is commonly missed without a properly done CISS sequence.<\/p>\n\n\n\n<p><strong>TREATMENT OPTIONS<\/strong><\/p>\n\n\n\n<p><strong>MEDICAL <\/strong>&#8211;\u00a0 <\/p>\n\n\n\n<p>This pain is responsive to anti seizure (fits) medications- carbamazepine, phenytoin, gabapentin.<\/p>\n\n\n\n<p>These patients can be given a trial of medications in slowly escalating doses of the above mentioned medicines if tumor has been ruled out on MRI brain.<\/p>\n\n\n\n<p><strong>SURGERY<\/strong><\/p>\n\n\n\n<p>If relief from medications is less than 70-80% ,pain is still intolerable inspite of maximum tolerable doses of medications and there is evidence of neurovascular contact on MRI , <strong><strong>the best form of treatment is minimally invasive microscopic vascular decompression\u00a0 of trigeminal nerve MVD<\/strong><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"596\" height=\"408\" src=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/tn-2.jpeg\" alt=\"\" class=\"wp-image-125\" srcset=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/tn-2.jpeg 596w, https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/tn-2-300x205.jpeg 300w\" sizes=\"(max-width: 596px) 100vw, 596px\" \/><\/figure>\n\n\n\n<p>Figure 1-&nbsp;&nbsp;&nbsp; TN \u2013 TRIGEMINAL NERVE<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"592\" height=\"351\" src=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-09-at-12.12.26-AM.jpeg\" alt=\"\" class=\"wp-image-120\" srcset=\"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-09-at-12.12.26-AM.jpeg 592w, https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-09-at-12.12.26-AM-300x178.jpeg 300w\" sizes=\"(max-width: 592px) 100vw, 592px\" \/><\/figure>\n\n\n\n<p>FIGURE 2<\/p>\n\n\n\n<p>80% patients have nearly immediate relief with MVD surgery. 10% patients may still require medications in small to moderate doses. Rest 10% will have no relief and may need percutaneous repeated radiofrequency lesioning.<\/p>\n\n\n\n<p><strong>RF LESIONING<\/strong><\/p>\n\n\n\n<p>\u00a0It is destructive procedure and has high recurrence rate of pain so reserved for selected patients.<\/p>\n\n\n\n<p><strong>RADIOSURGERY<\/strong><\/p>\n\n\n\n<p>Again this is destructive procedure and has more permanent results as compared to RF lesioning. To be opted for when other modalities have failed or patient is unfit for surgery.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trigeminal neuralgia is\u00a0 the\u00a0 worst pain known in medicine. It is a facial pain on one side of the face, in one or more division of trigeminal nerve(TN) This pain is compared to labour pain and kidney stone pain. It causes severe depression , so it is also called SUICIDE DISEASE CHARACTERISTICS OF PAIN: This [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42],"tags":[],"_links":{"self":[{"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/posts\/113"}],"collection":[{"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/comments?post=113"}],"version-history":[{"count":3,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/posts\/113\/revisions"}],"predecessor-version":[{"id":126,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/posts\/113\/revisions\/126"}],"wp:attachment":[{"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/media?parent=113"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/categories?post=113"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.drsonalbrainspinesurgeries.com\/blog\/wp-json\/wp\/v2\/tags?post=113"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}