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Welcome,

Trigeminal Neuralgia, aka Tic douloreaux  or  TN
&
Temporomandibular  Joint aka TMJ  Eventually Cancer.This website is about Brian Nelson's fight with a parotid (salivary) gland tumor. It started out with the symptoms of  Trigeminal Neuralgia, aka Tic douloreaux  or  TN & Temporomadibular Joint aka TMJ Click Here to see my other record file at IAmFightingCancer.com  Bookmark this page now!  
 Scan down to read my very lengthy and detailed web journal. Call me if I can help you. 713-467-3025 Brian

 

Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face. Compendium

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Page 5 of 7 Tim Guith Sections 101 to 125 Opiods

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 Page 6 of 7  Bilateral Facial Pain and Bitter Taste in the Mouth. http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/bilateral-facial-pain.html 

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You can find this site again  by typing  the word "neuralgia1" backwards, ie.  OR "1aiglaruen"in Google. Brian "

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If after you scan to the bottom of this  website and still can't find the information you are looking for try another Google search here.
Contact information for this Website:
 
Brian Nelson, Webpage Marketing Consultant 

 31 Gessner Rd. Houston, TX  09/06/2006 12:10 PM -0500
713-467-3025  Fax 713-467-3192  
Click: E-mail me
Trigeminal Neuralgia, aka Tic douloreaux  or  TN
&
Temporomandibular  Joint aka TMJ  Eventually Cancer.This website is about Brian Nelson's fight with a parotid (salivary) gland tumor. It started out with the symptoms of  Trigeminal Neuralgia, aka Tic douloreaux  or  TN & Temporomadibular Joint aka TMJ Click Here to see my other record file at IAmFightingCancer.com  Bookmark this page now!  
 Scan down to read my very lengthy and detailed web journal. Call me if I can help you. 713-467-3025 Brian
Hi,
1. CLICK for the very low priced Web Hosting service I use. Click Here for Prices or
E-mail me.

2. Let me put all your photos on the net to share with your friends at a low price.
E-mail.

3.
Make a difference in the World!  Publish the 1st chapter of your new book on the web for 99 cents. E-mail.

4. Attend Houston Very Motivational Classes "Making a Living on the Internet." by  Brian Nelson 713-467-3025 
E-mail

Brian
Signature Card For:                 Brian Nelson    31 Gessner Rd. , Houston, TX  77024
Tel. 713-467-3025 (Refers to my cell)      Fax 713-467-3192        
Click here to e-mail me.

www.NelsonIdeas.com
       Make a difference in the world!  "Idea Possibility Consulting"
www.BrianNelsonConsulting.com    There are so many new ways to make more profit. 
www.PartyTentCity.com 
                                The best modular party tent you can buy!
www.IamFightingCancer.com   Brian's story on Cancer and TN.  Post your Cancer story!

Bookmark this page now!

Misspelled Words on this pagetrigemnal, trigeminal, trigemial, trigeminl, tigeminal, trgeminal, trieminal, trigminal, trigeinal, trigeminar, tligeminal, tligeminar, tr1gen1ma1, tr1gen1mal, trigenimal, trigemimal, trigeminla, trigemianl, trigemnial, trigeimnal, trigmeinal, triegminal, trgieminal, tirgeminal, rtigeminal, trigemina, rigeminal, neuralgia, nuralgia, neralgia, neualgia, neurlgia, neuragia, neuralia, neuralga, neurargia, neurargai, neulalgia, neulalgai, neulargia, neulargai, neuralgai, neura1g1a, neuralg1a, meuralgia, neuraliga, neuraglia, neurlagia, neuarlgia, nerualgia, nueralgia, enuralgia, neuralgi, euralgia, tic, tik, tick, t1c, tci, itc,dou1oreaux, douloreaxu, douloreuax, douloraeux, douloeraux, doulroeaux, douolreaux, doluoreaux, duoloreaux, oduloreaux, douloreau, douloreax, douloreux, douloraux, douloeaux, doulreaux, douoreaux, doloreaux, duloreaux, ouloreaux, douloreaux,tenporomad1bu1ar, tenporomad1bular, tenporomadibular, temporomadibulra, temporomadibualr, temporomadibluar, temporomadiublar, temporomadbiular, temporomaidbular, temporomdaibular, temporoamdibular, tempormoadibular, tempoormadibular, temproomadibular, temopromadibular, tepmoromadibular, tmeporomadibular, etmporomadibular, temporomadibula, temporomadibulr, temporomadibuar, temporomadiblar, temporomadiular, temporomadbular, temporomaibular, temporomdibular, temporoadibular, tempormadibular, tempoomadibular, tempromadibular, temoromadibular, teporomadibular, tmporomadibular, emporomadibular, temporomadibular

Trigeminal Neuralgia, aka Tic douloreaux  or  TN
& Temporomadibular Joint
aka
TMJ  Eventually Cancer.

Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face. Compendium

Page 1 of 4 Section 1-25
   http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html ud 09/06/2006 12:10 PM -0500

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Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face.  Treatment is by medication, radiosurgery, craniofacial surgery or neurosurgery  or Microvascular Decompression  (MVD) for nerve pain relief. Trigeminal Neuralgia typically is near the nose lips, eyes, or ears.

This  compendium is also "Brian's Pain Journal". Let me hear about your face pain. I can publish on the web  anything you have to say about  trigeminal neuralgia. It will help other with face pain.  We can become "Pain Pals". The cause and permanent cure for
tic douloreaux (TN) are still unknown.  If your group would like a speaker about TN  call me. 

Page 3 of 4.

 
by  Brian Nelson
bnelson@PartyTentCity.com

713-467-3025 Houston,  TX 

  Hi Aiglaruen


MTNSB   Include page Pending Paste.

51

TNA In the News

 

 

 

52     Trigeminal Neuralgia (TN) or tic douloureux is an acute painful disorder of the fifth cranial (trigeminal) nerve and is referred to by many as the “suicide disease”.  TN produces excruciating, lightning strikes of facial pain, typically near the nose, lips, eyes or ears.  Something as simple and routine as brushing the teeth, putting on makeup, or even a slight breeze can trigger an attack, resulting in acute pain.  TN is not a fatal disease, but it is universally considered to be one of the most painful afflictions known. 

     The origin of TN is unknown, but it is often attributed to abnormal blood vessels that compress the nerve, multiple sclerosis, or tumors.  It usually takes from five to seven years for most patients to receive a correct diagnosis.  There is no known absolute cure for TN, but there have been tremendous advancements in surgical and medical treatments that have benefited many.  Initial treatment of TN usually begins with the use of anti-seizure drugs, but should the medication be ineffective or if it produces undesirable side effects, neurosurgical procedures are available that may relieve pressure on the nerve or reduce nerve sensitivity.  

     The TNA (Trigeminal Neuralgia Association) was founded in 1990 by TN patients and their families.  Until then, most TN patients suffered in isolation and fear and knew very little about the disorder and its treatment.  And, because many who do not have classic TN have turned to TNA for help, the Association mission now includes assisting and supporting those affected by related facial pain as well. 

     TNA’s mission is to support and educate patients and practitioners and to advocate for patients and facial pain research.  We have 75 support groups across the country as well as telephone support contacts to assist people in pain.  In addition, the TNA hosts a biennial national conference designed for patients and their supporters, support group leaders, neurosurgeons, neurologists, oral and maxillofacial surgeons, dentists, nurses, health-related professionals, and medical industry representatives, who have an interest in the management of facial pain related to trigeminal neuralgia and related facial pain conditions.

 

 
 
 

53Table of Contents

Part One: Characteristics and Causes of Trigeminal Neuralgia
   I.  An Overview of Trigeminal Neuralgia (Tic Douloureux)
   II. Anatomy of the Trigeminal Nerve
   III. Types of Trigeminal Neuralgia and Their Causes
       A. Introduction
       B. Typical Trigeminal Neuralgia
       C. Atypical Trigeminal Neuralgia
       D. Pre-Trigeminal Neuralgia
       E. Multiple-Sclerosis-Related Trigeminal Neuralgia
       F. Secondary or Tumor Related Trigeminal Neuralgia
       G. Trigeminal Neuropathy or Post-Traumatic Trigeminal Neuralgia
       H. "Failed" Trigeminal Neuralgia
 

 

YOUR COMPLETE GUIDE TO TRIGEMINAL NEURALGIA
Anthony M. Kaufmann & Mitesh Patel
Centre for Cranial Nerve Disorders, University of Manitoba, Health Sciences Centre
Winnipeg, Manitoba, Canada

 

Click Here to

Begin or choose a section below.

Part Two: Treatment of Trigeminal Neuralgia
   I. Overview of Treatments
   II. Medications
       A. Introduction
       B. Carbamazepine (Tegretol®)
       C. Phenytoin (Dilantin®)
       D. Baclophen (Lioresal®)
       E. Gabapentin (Neurontin®)
       F. Trileptal (Oxycarbazepine®)
   III. Surgery
       A. Overview
       B. Microvascular Decompression Surgery
       C. Nerve Injury/Destructive Procedures (Rhizotomies)
       
    1. Introduction
           2. Types of Rhizotomies
               a. Percutaneous Glycerol Rhizotomy
               b. Percutaneous Balloon Compression Rhizotomy
               c. Radiofrequency Rhizotomy
               d. Stereotactic Radiosurgery (Gamma Knife)
               e. Peripheral Trigeminal Nerve Blocks, Sectioning and Avulsions
                f. Microsurgical Rhizotomy

 

  Gamma-knife radiosurgery: Neurosurgery without  scalpel

By
Mayo Clinic staff
54 Gamma-knife radiosurgery. The words may sound foreign, and a bit scary, especially when you realize that gamma-knife surgery is performed on the brain. But gamma-knife radiosurgery can be a very effective way to treat brain tumors and other brain abnormalities, particularly those that can't be treated with traditional neurosurgery.

The gamma knife isn't actually a knife. Rather, it's a special machine that focuses high-intensity radiation into a small area. The radiation damages and destroys the unhealthy brain tissue. "The gamma knife is a cylindrical array of 201 sources of radiation aimed at one point," says Bruce Pollock, M.D., a neurosurgeon at Mayo Clinic, Rochester, Minn. "The individual radiation of each beam is low, but at the focal point of the gamma knife, a very high dose of radiation can be delivered."

This can be particularly useful for brain tumors located in areas of the brain that are hard to reach by means of conventional surgery. In addition to treating previously hard-to-reach areas, gamma-knife radiosurgery has many other benefits. It typically requires only a mild sedative and local anesthesia, is relatively painless and, because no surgical incisions are made, has none of the postoperative complications — such as bleeding or infection — commonly associated with surgery.

Signature Card For:                 Brian Nelson    31 Gessner Rd. , Houston, TX  77024
Tel. 713-467-3025 (Refers to my cell)      Fax 713-467-3192        
Click here to e-mail me.

www.NelsonIdeas.com
       Make a difference in the world!  "Idea Possibility Consulting"
www.BrianNelsonConsulting.com    There are so many new ways to make more profit. 
www.PartyTentCity.com 
                                The best modular party tent you can buy!
www.IamFightingCancer.com   Brian's story on Cancer and TN.  Post your Cancer story!

55Trigeminal Neuralgia
AKA; "Tic Doloureux"

This condition is rare, but for those who suffer from
it, the worst pain imaginable will torment the patient!

Here are Some Informative Websites:
Trigeminal Neuralgia Homepage
Trigeminal Neuralgia Links/Resources
Harvard Medical School: Surgery for Microvascular Compression Syndromes
Percutaneous Stereotactic Radiofrequency Thermal Rhizotomy for Trigeminal Neuralgia
Trigeminal Neuralgia and Facial Pain
Trigeminal Neuralgia Association Home Page
Trigeminal Neuralgia Support Association has a Handbook on TGN!
Surgical treatment of Trigeminal Neuralgia and Hemifacial Spasm
NORD documents on Trigeminal Neuralgia
Trigeminal Neuralgia Resources Homepage
Medifax Site on Trigeminal Neuralgia
Debbie Creps' Trigeminal Neuralgia Resources
National Institute of Neurological Disorders & Stroke: an article onTN
A personal narrative of the TN Experience
Trigeminal Neuralgia Surgery
Neuroscience Course NS11: Sensory Physiology - Trigeminal: Deep Reading!!
Peter J Jennetta: Microvascular Neurosurgeon's TN Information
Root Canal Treatment: Is There a Cover-up?
Tegritol: Carbamazepine: A drug preferred as TN Treatment
TNA Book Available on TN!

Back to Neurological Resources page
Back to Medical Page

56 TRIGEMINAL NEURALGIA

Trigeminal neuralgia (TN) is paroxysmal triggered face pain. Most patients respond very well to radiosurgery with the Gamma Knife, which is one of the best standard treatments for this condition.

Symptoms
Trigeminal neuralgia is characterized by sudden bursts (paroxysms) of face pain. These bursts are often triggered by a light touch around the mouth or face or by talking, eating, or brushing one's teeth. The pain sometimes gets worse or better for periods of weeks or months. The pain is in the areas supplied by the trigeminal nerve: the cheeks, jaw, teeth, gums, lips and less often around the eye or forehead. Usually pain occurs on just one side of the face, but in five to 10 percent of patients, pain occurs on both sides of the face, although not at the same time. The pain responds to Tegretol (carbamazepine is the generic name), but sometimes the dose has to be increased and unpleasant side effects can occur.

Atypical features may coexist with some of the previously described symptoms. These atypical features may include a constant pain that is not always triggered by light touch. Patients with constant pain and TN are sometimes diagnosed as having atypical trigeminal neuralgia. Gamma Knife radiosurgery and other treatments for TN usually relieve the sharp electric-like pains that are triggered by light touch, but are less likely to relieve the constant, untriggered pains.

Incidence and Prevalence
Approximately 14,000 people develop TN each year in the United States; about 140,000 people have the condition. Trigeminal neuralgia is more common in patients with multiple sclerosis.

Cause
The cause of trigeminal neuralgia is not always certain. Approximately five percent of patients have a tumor pressing on the trigeminal nerve where it leaves the brain, while other patients have a blood vessel that presses on the trigeminal nerve, close to the brain. In some patients the cause cannot be determined.

Approximately five percent of patients with trigeminal neuralgia have multiple sclerosis. Patients with TN and multiple sclerosis are generally younger, and tend to first experience TN symptoms while in their mid 40s. These patients are more likely to have pain on both sides of the face (bilateral trigeminal neuralgia) and often have other neurological abnormalities, such as weakness or numbness in the arms or legs, dizziness, unsteadiness and double vision. Most patients in their 40s and 50s who have trigeminal neuralgia do not have multiple sclerosis. Patients who have TN but not multiple sclerosis tend to first experience TN symptoms while in their mid 50s.


Diagnosis
In addition to a thorough history and physical examination, magnetic resonance imaging (MRI) of the brain is recommended. This procedure helps identify a brain tumor in the rare cases in which it is present along with TN. It may also help to diagnose multiple sclerosis. Often when the MRI is performed, some contrast material is injected into the vein so that the appearance of a small tumor, blood vessel, or other structures in the brain can be enhanced and made easier to detect.

Nonsurgical Treatment
There are some patients who have very mild face pain that may subside and even disappear without treatment. For severe pain, medications, especially Tegretol, are often highly effective. Tegretol can cause many side effects including sleepiness, forgetfulness, confusion, drowsiness, dizziness and nausea. Tegretol can also cause more serious problems such as bone marrow suppression, which can lead to anemia or a decrease in the number of white blood cells. A low white blood cell count can predispose a patient to contracting an infection. Rarely, these problems are life threatening. Blood counts must be monitored in order to lessen the chance of these complications occurring. Tegretol can also harm many other parts of the body, so patients who take this medicine must be under careful medical supervision. Tegretol interacts with many medications, so patients must advise their doctor of all the medications they are taking. Elderly patients and those with multiple sclerosis are more likely to experience the side effects of Tegretol.

There are other medications that can be used either alone or in combination to control trigeminal neuralgia pain. These are usually less effective than Tegretol. They include Lioresal (baclofen), Dilantin (phenytoin), Klonopin (clonazepam), Neurontin (gabapentin), or Lamictal (lamotrigine). All of them, except baclofen, are also used to prevent seizures.

Surgical Treatment
A surgical procedure is recommended for patients who continue to experience severe pain or side effects from medications. In the past, patients with TN did not consider neurosurgical options until the pain or medicines became unbearable, because surgical procedures carried higher risks. Now that surgery is safer, and especially with GKRS, which is not only highly effective but safer than any of the other procedures, patients no longer have to wait to be in agony in order to undergo neurosurgical intervention.

There are five important neurosurgical procedures. Each is effective, but not always, and occasionally has to be repeated. These procedures are: Gamma Knife radiosurgery (GKRS), radiofrequency electrocoagulation (RFE), glycerol injection (GLY), balloon microcompression (BMC), and microvascular decompression (MVD). All of these procedures treat the trigeminal nerve at around the same place, close to where it leaves the brain.

Gamma Knife radiosurgery is the most recent and least invasive neurosurgical treatment for trigeminal neuralgia. Of all the surgical procedures, it is least likely to cause complications and uncomfortable new facial sensations (dysesthesias).


What is Gamma Knife Radiosurgery?
Gamma Knife radiosurgery is a method for treating certain problems in the brain without making an incision. Two hundred-one beams of cobalt-60 radiation are focused precisely on a specific region in the brain. In the case of TN, the target area is the trigeminal nerve, just where it leaves the brain. The treatment does not require general anesthesia, and the patient stays in the hospital for less than five hours.

Who is a candidate for Gamma Knife Radiosurgery?
Any patient with trigeminal neuralgia who has pain or has difficulty with the medicines used to relieve the pain is an excellent candidate for GKRS. The patient's age or medical condition does not affect the decision to have GKRS. Even the elderly or medically infirm can undergo this treatment. Patients who are receiving anticoagulants for other medical conditions do not have to stop or reverse the anticoagulation therapy prior to GKRS. Those who have had previous procedures for TN may also undergo GKRS. Patients who are concerned about the possibility of numbness are particularly good candidates for GKRS, because the chance of postoperative numbness occurring is very small. Patients who poorly tolerate medicines given for sedation and relief of pain during a procedure are also very suitable for GKRS because these medications are not necessary.

What results can be expected from GKRS?
Excellent or good pain relief occurs in approximately 85 to 90 percent of patients. Onset of pain relief may occur one day to four months after the procedure. About half of patients will experience pain relief within four weeks. Recurrent pain occurs within three years in 10 percent of patients. Patients with TN and multiple sclerosis are less likely to respond to GKRS than those without multiple sclerosis, although they also may be helped by the procedure. Gamma Knife radiosurgery can be repeated, but not until at least four months after the original procedure.

What are the complications from GKRS?
Major complications have not been reported. Additional numbness in the face or new facial sensations occur in less than 10 percent of patients. There are theoretical possibilities of delayed complications such as brain damage or brain tumor formation, but these are rare and have not been reported to occur in any patients treated for trigeminal neuralgia.

Gamma Knife radiosurgery was first performed in Sweden in the 1950s, but few patients were treated for TN. The Gamma Knife has been used in the United States since 1987, and most cases of TN have been treated during the past five years. Although there is not much information on long term effects, initial and medium range follow-up suggest that GKRS is not only effective but also very safe.


Linear Accelerator Radiosurgery
There is another form of radiosurgery, called LINAC (Linear Accelerator) radiosurgery. It uses high-energy X-rays delivered by a sequence of arcs, and is very different from GKRS. Only a few cases of TN have been treated with LINAC radiosurgery, and there are no reports on these cases in peer-reviewed journals. Unlike GKRS, LINAC radiosurgery has not been demonstrated to be an effective and safe treatment for trigeminal neuralgia.

Radiofrequency Electrocoagulation, Glycerol Injection and Balloon Microcompression
These procedures are performed through a needle that is inserted into the face and directed, under X-ray guidance, toward the trigeminal nerve. All of these procedures partially damagee facial numbness, which is sometimes very painful. Major complications, such as bleeding or infection in the brain, are rare but can be devastating when they occur.

Microvascular Decompression
Microvascular decompression is a major neurosurgical procedure in which the skull is opened. During the operation, which requires general anesthesia, the surgeon sees the nerve. If he or she finds a blood vessel pressing on the trigeminal nerve, a soft piece of material will be placed between the blood vessel and the nerve, thus lifting the blood vessel away from the nerve. This operation carries greater risks than the other procedures do, and these risks, although infrequent, include possible death, stroke, bleeding, infection, inflammation of the surface of the brain, facial weakness, hearing loss, facial numbness and pain.

Summary
Gamma Knife radiosurgery is a major advance in the treatment of trigeminal neuralgia, an otherwise agonizing condition characterized by paroxysmal triggered face pain. Gamma Knife radiosurgery not only relieves the pain as well as the other neurosurgical forms of treatment, but it does so with fewer complications.

The Gamma Knife is the only radiosurgical machine for which positive results of trigeminal neuralgia treatment have been published in peer-reviewed journals.

Dr. Brisman is a graduate of Harvard Medical School and served as Chief of Neurosurgery US Army 24th Evacuation Hospital in Vietnam. He has performed more than 1400 surgical procedures on TN patients and more than 125 radiosurgical procedures. He serves on the Medical Advisory Board to the Trigeminal Neuralgia Association. He may be reached at Columbia Presbyterian Medical Center in New York City at +212-305-5285 or by e-mail at: rb36@columbia.edu.

57

Trigeminal Neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia (also known as tic douloureux) is a facial pain syndrome that usually develops in individuals over 50 years old. Its incidence is 4/100,000, and it is the most common facial pain sydrome in this age group.

The character of trigeminal neuralgia is classically lancinating or "electric-like shocks" lasting a few seconds but of a debilitating, intense nature. They are usually on one side of the face, most often in the area of the upper cheek down to the level of the jaw, the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve. The ophthalmic division (V1), transmitting sensation from the skin of the forehead and the eye, is less commonly involved. The trigeminal nerve is also known as cranial nerve V. It transmits sensation from the face, eyes and teeth and controls the muscles of mastication (chewing).

Painful attacks may occur spontaneously but are more often associated with a specific stimulus in a "trigger area." Common trigger points are the eyebrow for ophthalmic division pain, the upper lip for maxillary division involvement, and the lower molar teeth for mandibular division pain. Sensory stimuli by touch, cold, wind, talking or chewing can precipate the attacks. Pain-free intervals last for minutes to weeks, but long-term spontaneous remission is rare. The attacks cease during sleep but often occur upon arising in the morning. This constellation of symptoms provides the diagnosis.

What causes trigeminal neuralgia?

The short answer is, "No one knows." There is considerable evidence, however, that vascular compression of a nerve root is the cause. This may be due to branches of the superior cerebellar artery, basilar artery, or local veins compressing the trigeminal nerve root. In younger patients, trigeminal neuralgia can be caused by tumors in the region of cranial nerve V or (more commonly) by multiple sclerosis. These entities must therefore be ruled out. Imaging studies, CT or MRI with and without contrast enhancement, should be performed on every patient with trigeminal neuralgia. Often, elongated and tortuous vessels can be seen and tumors of the region need to be excluded as a cause for the syndrome.

Treatment

Pharmacological

The primary treatment of trigeminal neuralgia is pharmacological. Most patients obtain relief, at least initially, within 30 minutes of administration of carbamazepine (Tegretol). This drug does have side effects — mostly bone marrow depression and liver damage — and patients should be monitored by their physician. Some individuals may also respond to phenytoin (Dilantin).

Surgical

After pharmacologic failure, surgical intervention is necessary. Surgical options include blocking the trigger point with local blocks, neurectomy — block of the nerve branches, percutaneous rhizotomy of the trigeminal ganglion (destruction of the site of sensory nerve cell bodies just inside the skull and dura), and microvascular decompression of the nerve root zone. Decisions on which treatment is best for a given patient must be based on the nature of the pain, the health of the patient, imaging findings and consultation with the neurosurgeon.

Who should I contact?

Dr. Robert Goodman, Department of Neurological Surgery
Telephone Number: (212) 305-3774

 

Dr. Guy McKhann, Department of Neurological Surgery
Telephone Number: (212) 305-0052

Dr. Ronald Brisman, Department of Neurological Surgery
Telephone Number:(212) 305-5285

58 I apologize for my guestbook being down for so long. Below is the link for my new guestbook.

Read or add to the
Guestbook.
 

Disclaimer

Trigeminal Neuralgia Association (TNA) Homepage

Be sure to check out the two WebRings at the bottom of this page.

Conference Photos

Jane Utti's Conference Notes

 

58
 
  • RxList - The Internet Drug Index
  • Drug treatments for TN - The National Institute of Neurological Disorders and Stroke (NINDS) has written a simple introduction to pain medications. Though applicable to neurological pain syndromes in general, the article contains good specific references to TN medications aswell. See NINDS: New & Old Drugs for Pain.
  • Carbamazepine Brand name: Epitol, Tegretol - Anticonvulsant - Trigeminal Neuralgia Therapy - Antimanic
  • Drug Interaction Database ( This site is not always available )

  • Leksell Gamma Knife®
    TECHNOLOGY - Explains the basics of Gamma Knife technology. How it works and what it does. Includes QuickTime® video and press coverage.
    INDICATIONS TREATED - Contains cumulative treatment data, organized by indication, from Gamma Knife centers around the world.
    THE PROCEDURE - Provides an overview of the four steps to a Gamma Knife procedure.
    WORLDWIDE LOCATIONS - A current (as of Jan. 1996) listing of all the locations providing Gamma Knife treatments with links to web sites, where available.
    PATIENT SUPPORT - Organizations who's mission it is to support and educate patients, with links to web sites where available.
    BIBLIOGRAPHY - Contains all articles and books published concerning the technology and results of Gamma Knife treatments, organized by indication.
  • Gamma Knife Radiosurgery for trigeminal neuralgia: Results and Expectations
  • University of Pittsburgh Center for Image-Guided Neurosurgery: Our mission is to function as a world leader in the Development, Investigation, and Use of Minimal Access, Minimally Invasive Neurosurgical procedures to enable safer and more effective treatments for patients with brain disorders.
  • Microvascular Decompression of The Cranial Nerves - "Trigeminal neuralgia is first treated medically and Tegretol (carbamazepine) is the most effective medicine. Other medications can be added or used as well and these include Dilantin (phenytoin), Baclofen (lioresal) and Neurontin (gabapentin). However, in many cases medication needs and patients experience either breakthrough pain or undesirable side effects. In this case, operation is considered an option. The microvascular decompression operation offers the best chance of long term relief and the best quality of life of any of the available surgical procedures, and does so by providing relief of the pain without the production of numbness as is necessary with the destructive/ablative procedures.

    Results: Microvascular decompression has been performed at the University of Pittsburgh Medical Center over the last 25 years in over a thousand patients with trigeminal neuralgia. With careful follow-up it is clear that this operation offers the best chance of good long term cure of pain without the need for medication or any of the alternative surgical procedures. Initially almost everyone experiences relief of discomfort but there is, however, a recurrence rate over time. Even so, the recurrence rate is relatively small and after 20 years of follow-up, 75-80% of the patients are completely free of pain without the need for medication, making this most effective procedure to date."
  • Peter Joseph Jannetta, M.D., D.Sc.
  • Microvascular Decompression - Photographic discription of the operation.
  • Percutaneous Glycerol Rhizotomy ( no information )
  • Percutaneous Stereotactic Radiofrequency Thermal Rhizotomy - "Percutaneous Stereotactic Differential Radiofrequency Thermal Rhizotomy is a surgical procedure that was developed in the 1960's and has been modified by physicians at the Massachusetts General Hospital for the treatment of trigeminal neuralgia. This procedure creates a precise thermal lesion of the trigeminal nerve which interrupts the transmission of pain signals to the brain, while preserving touch sensations of the face. Radiofrequency Thermal Rhizotomy does produce some mild numbness of the face in the region of the pain, which is usually quite tolerable. It does not effect the nerve function to the muscles of the face, therefore facial paralysis is not a concern."

  • Trigeminal Neuralgia - Facial Pain - Disscussion TN-L:
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    tn-l@uafsysb.uark.edu with the following command in the text (not the subject) of your message: SUBSCRIBE TN-L (YOUR NAME)
  • The Cleveland Clinic Neurology Forum:
    Cleveland Clinic - People can post individual, neurology-related questions in this forum. Neurologist's from The Cleveland Clinic will respond to these questions, in lay terminology. This forum gives people direct access to neurologists within a world renowned medical organization!
  • Neurology Web-Forum:
    MGH Neurology
  • Western Australia - Trigeminal Neuralgia Support Group (Tic Douloureux)

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