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Suggest treatment for neuralgia curable

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
Practicing since : 1994
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hello doctor. my name is XXXX ,33 y . I am suffering from occipital neuralgia since I was 18 y ,please please please tell me if there is hope to treat my disease , because I am student and i cant read ,its threat my futre please, to know I went to a doctor in Australia he use corteson intention ,endep tablet ,lyrica tablet , it does not work , lastly he referred me to neurologist , but the neurologist said i cant make operation because 50%of people who they do the operation get worst please please , help me forgive me to my English. Doctor, I have had chronic occipital neuralgia as prescribe by Doctor Mark kraig , I have taken an MRI spine and its was clear with out any problem in my spine cord ,first stage the Doctor start with corteson injection,next endep tablet,and then lyrica tablet with corteson inject but all of them does not work ,lastly he refereed me to an radilogist to do the operation ,but the radiologist did no agree to did it because he said that 50%of patient who they did radiologist operation to burn the nerve they get worst , so i do not know what to do pleas please pleas ,if there is any thing you can help me because now I am student and wont to study but I ant because it hurt me to do anything and it is threaten my future ,now I am hopeless ,and need your help . please . kind regards . XXXX
Posted Sat, 22 Feb 2014 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer: My reply is below. Detailed Answer: HiXXXX, Thank you for posting your query. I have noted your symptoms and the treatment received so far. It is unfortunate that you have not improved despite medicines and steroid injections. The best medicines for occipital neuralgia are carbamazepine and oxcarbazepine. If you have not used them, you can use one of them. I usually start them at a dose of 200 mg two times daily, and depending on the response, the dose may be increased to 600 mg two times daily. Occipital nerve blocks are another option for treating this condition. This is done by giving an injection by an anaesthetist. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in
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Follow-up: Suggest treatment for neuralgia curable 6 hours later
Hello Doctor. thank you for respond.I want to ask you what is the side effects of block nerve what is its risks because there is a Doctor who told me that is 50% of people who did it they get worst is that true,and what is inject include .Another thing I have not use that medication you mentioned ,please tell me what is the side effects of that medicine .Is there food or body posture effect my case should I avoid them . I wish to meet you ,but want to ask the cost of operation or treatment ,If I came to your clinic ,because I am studying in Australia now. kind regards XXXX
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for getting back. Occipital nerve blocks are safe and do not cause worsening in most people. The injection consists of a mixture of lidocaine (local anaesthetic) and triamcinolone (steroid). The injection can be given maximum three times in a six month period. The medications (carbamazepine and oxcarbazepine) are safe and do not cause any serious side effects. Some people may feel dizzy for a few days and very few may have allergy/skin rash. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: Suggest treatment for neuralgia curable 31 hours later
Hello Doctor, what do you recommend me to do .because i took the strongest drug here in Australia which I told you (lyrica)but it does not work ,I do not want to continue on having drug ,please I need permanent treatment .if you need any reports or MRI scan I will attach them to you ,or if you now that visiting your clinic it gaves me hope cure please told me.
 
 
Answered by Dr. Sudhir Kumar 6 hours later
Brief Answer: My reply is below. Detailed Answer: Thank you for getting back. I can understand your discomfort on account of persistent pain and lack of response to lyrica (pregabalin). You may upload the MRI. I would also be pleased to see you in Hyderabad, India for further treatment. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: Suggest treatment for neuralgia curable 32 hours later
Hello doctor , I attached the MRI but , please if you see anything not normal told me because I want to now really I have no problem with my spine and if you can give me any hope to fix my problem permanently , because am suffering a lot ,even I cannot study just for one hour . kind regards XXXX hello doctor . this is doctor report I think the MRI is too much to upload here so i will sent it by email . kind regards XXXX
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for getting back with MRI report. MRI shows mild slipped disc in the neck region with pinching of nerve. This would get better with physiotherapy and neck extension exercises. In addition, there is pressure on the lower part of brain (brainstem) with a blood vessel. This may require surgery, if it is producing symptoms (such as difficulty in swallowing or speaking, weakness or imbalance while walking, etc). As of now, no surgery is required for that. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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