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Having trigeminal neuralgia & tinnitus. No sleep. Suggest medication

Dec 2012
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General & Family Physician
Practicing since : 2012
Answered : 1694 Questions
My 87 yr old mother has trigeminal neuralgia & tinnitus & can't sleep. takes hbp meds & tegretol & has a pacemaker. She has tried herbal teas to sleep. Is there a sleeping pill she can take? & is there anything else available for the nerve pain?
Posted Tue, 5 Nov 2013 in Ear, Nose and Throat Problems
Answered by Dr. Nsah Bernard 58 minutes later
Brief Answer:
Various treatment options exist

Detailed Answer:

Thanks for posting,

I am sorry for all your neuropsychiatric problems that your mother must be enduring. I can not just start imagining how difficult it must be to care for such a person.
How ever, there are several treatment options available to remedy this situation which are proven over the years to be very effective and I basically manage some of my patients with some of them. I will go straight to the point with available treatments.
Note that the treatment for trigeminal neuralgia will also be effective for her insomnia or sleeplessness (given first of that the trigeminal nerve pain might be the cause of her difficulty to sleep). These medications have sedative effects too that can cause her to be sleeping.
Your neurologist, or a pain specialist may be involved in your care.
Certain medicines sometimes help reduce pain and the rate of attacks. These medicines include:
- Anti-seizure drugs (carbamazepine, gabapentin, lamotrigine, phenytoin, valproate, and pregabalin)
- Muscle relaxants (baclofen, clonazepam)
- Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)

Some patients may need surgery to relieve pressure on the nerve. Techniques include:
- Cutting or destroying part of the trigeminal nerve (comes with side effect of parathesia)
- Destroying the trigeminal nerve with a needle or probe placed through the skin using radiofrequency ablation or an injection of glycerol
- Electrostimulation
- Percutaneous balloon microcompression
- Removal of the tumor (when a tumor is the cause)
- Stereotactic radiosurgery (Gamma knife)
- Surgery to remove a blood vessel that is putting pressure on the trigeminal nerve (called microvascular decompression, or MVD).
The surgical technique will depend on the doctor handling it. A neurosurgeon will be best placed to do any surgeries on your mother.

Hope this information helps and serve a purpose for your mother's well being.

Dr. Nsah
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