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Suggest Treatment For Trigeminal Neuralgia
Question: i have been diagnosed with 'trigeminal neuralgia'' and also have MS under treatment.
(rebif/baclophen/gabapentin). rebif is an interferon type subcutaneous injection.
it is assumed the TN is a side effect of MS, a demialinization of the trigemina, or plaque in the brain, therefore, inoperable. however, it could be ''mechanical, and therefore, correctable -a pinched nerve at the skull entry point. in any case, it is much more serious in it's effect on my life than the MS. a $40K operation would tell for sure! soft tissue scans were ''too close to call''.
i have been hearing about ''low-dose'' naltrexone....at first as a pain treatment,
but now i see it is also used for MS generally. my nuroligist vetos any suggestion that we try it. is there any history of L.D.N. as a treatment for trigeminal neuralgia that i can use to support my argument? i don't think he wants to switch treatments from rebif to L.D.N.meanwhile, neither do i, but over 20 years, the suppression of my white blood cells has wrecked havoc with minor infections becoming major., and the present protocol does little for pain.
i may have to seek another nuroligist. do you know of any using LDN? comments??
sorry to be so long on background, just trying to be helpful.XXXX
(rebif/baclophen/gabapentin). rebif is an interferon type subcutaneous injection.
it is assumed the TN is a side effect of MS, a demialinization of the trigemina, or plaque in the brain, therefore, inoperable. however, it could be ''mechanical, and therefore, correctable -a pinched nerve at the skull entry point. in any case, it is much more serious in it's effect on my life than the MS. a $40K operation would tell for sure! soft tissue scans were ''too close to call''.
i have been hearing about ''low-dose'' naltrexone....at first as a pain treatment,
but now i see it is also used for MS generally. my nuroligist vetos any suggestion that we try it. is there any history of L.D.N. as a treatment for trigeminal neuralgia that i can use to support my argument? i don't think he wants to switch treatments from rebif to L.D.N.meanwhile, neither do i, but over 20 years, the suppression of my white blood cells has wrecked havoc with minor infections becoming major., and the present protocol does little for pain.
i may have to seek another nuroligist. do you know of any using LDN? comments??
sorry to be so long on background, just trying to be helpful.XXXX
Brief Answer:
LDN proved efficacious,needs management
Detailed Answer:
Thank you for asking!
Trigeminal Neuralgia is an adverse effect of MS. so you are very right.and glycerol rhizotomy (GR) and radiofrequency thermocoagulation with glycerol rhizotomy (RFTC-GR) are the treatment of choices in your case.
Now the Low Dose Naltrexone has been approved efficacious in many pain conditions but its main indication is for fibromyalgia. But it still works for neuralgia but the severity of pain is quite high in TN so the pain might not go away completely with LDN.
Rest many management plans like antiepileptic drugs, Carbamazepine Therapy,Gabapentin Therapy,Lamotrigine Therapy,Phenytoin Therapy,Non-antiepileptic Drug Therapy,Surgical Considerations,Microvascular Decompression,Percutaneous Procedures like PRTG, PRGR, and PBM and Gamma Knife Surgery has been devised for trigeminal neuralgia and consultant to a neurologist will help select the best one for you.
Now the MS, as you are already having management with meds and be compliant with that. here are some other tips which might prove helpful.
1- Exposure to the sun and vitamin D supplements really help delay the progression of the disease and help the myelination.vitamin D in doses up to 3000 IU daily can be taken; maintaining these levels appears to require doses of 500 to 800 IU daily
2-No smoking. As it increases the odds 300 times than normal non smokers to get MS and then its progression.
3-Keep sodium intake less than 2 gm per day and it eill help MS.
4-Reduce weight and keep the BMi less than 25 and it will help MS.
5-Remember The Uhthoff phenomenon which is an exacerbation of MS symptoms that is induced by exercise, a hot meal, or a hot bath. So nothing hot in food or in environment.
6-More use of Poly Unsaturated Fatty Acids to help the MS reversibility like linoleinc acids, omega 3 and 9 fatty acids.
7-Physiotherapy and stretching exercise in cool (less than 86 degree fahrenheit) pools using buoyancy will help.
8- Transcutaneous electrical nerve stimulation (TENS) is useful
9- Mechanical aids like ankle feet orthoses and WalkAide and Bioness help a lot.
10-occupational therapies with following four goals is advised..
Maintaining a consistent routine
Making lists
Keeping a daily planner
Organizing the home or work environment.
I hope it helps. Dont forget to close the discussion please
May the odds be ever in your favour.
S Khan
LDN proved efficacious,needs management
Detailed Answer:
Thank you for asking!
Trigeminal Neuralgia is an adverse effect of MS. so you are very right.and glycerol rhizotomy (GR) and radiofrequency thermocoagulation with glycerol rhizotomy (RFTC-GR) are the treatment of choices in your case.
Now the Low Dose Naltrexone has been approved efficacious in many pain conditions but its main indication is for fibromyalgia. But it still works for neuralgia but the severity of pain is quite high in TN so the pain might not go away completely with LDN.
Rest many management plans like antiepileptic drugs, Carbamazepine Therapy,Gabapentin Therapy,Lamotrigine Therapy,Phenytoin Therapy,Non-antiepileptic Drug Therapy,Surgical Considerations,Microvascular Decompression,Percutaneous Procedures like PRTG, PRGR, and PBM and Gamma Knife Surgery has been devised for trigeminal neuralgia and consultant to a neurologist will help select the best one for you.
Now the MS, as you are already having management with meds and be compliant with that. here are some other tips which might prove helpful.
1- Exposure to the sun and vitamin D supplements really help delay the progression of the disease and help the myelination.vitamin D in doses up to 3000 IU daily can be taken; maintaining these levels appears to require doses of 500 to 800 IU daily
2-No smoking. As it increases the odds 300 times than normal non smokers to get MS and then its progression.
3-Keep sodium intake less than 2 gm per day and it eill help MS.
4-Reduce weight and keep the BMi less than 25 and it will help MS.
5-Remember The Uhthoff phenomenon which is an exacerbation of MS symptoms that is induced by exercise, a hot meal, or a hot bath. So nothing hot in food or in environment.
6-More use of Poly Unsaturated Fatty Acids to help the MS reversibility like linoleinc acids, omega 3 and 9 fatty acids.
7-Physiotherapy and stretching exercise in cool (less than 86 degree fahrenheit) pools using buoyancy will help.
8- Transcutaneous electrical nerve stimulation (TENS) is useful
9- Mechanical aids like ankle feet orthoses and WalkAide and Bioness help a lot.
10-occupational therapies with following four goals is advised..
Maintaining a consistent routine
Making lists
Keeping a daily planner
Organizing the home or work environment.
I hope it helps. Dont forget to close the discussion please
May the odds be ever in your favour.
S Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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