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Suggest Treatment For Trigeminal Neuralgia
Question: Good Morning Dr. XXXXXXX
My name is XXXX and I reside in California. I'm sending this email on behalf of my wife who is suffering from trigeminal neuralgia. She is a 65 year old female. She is currently taking Tegretol which is numbing the pain with side effects such nausea and extreme tiredness. After consulting with her doctors they have recommended laser radiation with consequences such as partial or complete numbness of the face. 9 years ago she under went micro vascular decompression surgery and was perfectly well without symptoms until a month ago. We would like to know your opinion and we will send reports if you request. We would like to know if there are alternate treatments available. I come from a educated family of doctors including optometrists, dentists, and physicians. We highly respect your opinion. For further questions or concerns please feel to contact me on my cell phone at 707-217-8356 or email at YYYY@YYYY .
XXXX
My name is XXXX and I reside in California. I'm sending this email on behalf of my wife who is suffering from trigeminal neuralgia. She is a 65 year old female. She is currently taking Tegretol which is numbing the pain with side effects such nausea and extreme tiredness. After consulting with her doctors they have recommended laser radiation with consequences such as partial or complete numbness of the face. 9 years ago she under went micro vascular decompression surgery and was perfectly well without symptoms until a month ago. We would like to know your opinion and we will send reports if you request. We would like to know if there are alternate treatments available. I come from a educated family of doctors including optometrists, dentists, and physicians. We highly respect your opinion. For further questions or concerns please feel to contact me on my cell phone at 707-217-8356 or email at YYYY@YYYY .
XXXX
Brief Answer:
Radio frequency ablation seems to the best option.
Detailed Answer:
Hi Mr XXXXXXX XXXXXXX
Thank you for posting your query about your wife.
I have noted your wife's diagnosis, past treatments and current medications.
The fact that she has side effects to tegretol and in addition, has no significant relief from pain, means that we need to look for alternative options.
Radio frequency ablation (RF ablation) is the best option at present, as it is tested over several years and has efficacy going up to 85%. I agree partial numbness over face may occur in a minority, however, it does not lead to any significant disability.
Another alternative option would be Botox injections. This includes giving botox injections on the affected side of face. The injections are given in the skin, where the nerve endings of trigeminal nerve are located. This provides good relief, as I have seen in about 10 patients. Some other neurologists have also observed this.
You should note that botox is not FDA approved for trigeminal neuralgia, however, it is approved for a host of other painful conditions, including migraine headaches.
Doing second microvascular decompression is not an option now, as it is technically very demanding, and very few surgeons can do the second surgery well.
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, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Radio frequency ablation seems to the best option.
Detailed Answer:
Hi Mr XXXXXXX XXXXXXX
Thank you for posting your query about your wife.
I have noted your wife's diagnosis, past treatments and current medications.
The fact that she has side effects to tegretol and in addition, has no significant relief from pain, means that we need to look for alternative options.
Radio frequency ablation (RF ablation) is the best option at present, as it is tested over several years and has efficacy going up to 85%. I agree partial numbness over face may occur in a minority, however, it does not lead to any significant disability.
Another alternative option would be Botox injections. This includes giving botox injections on the affected side of face. The injections are given in the skin, where the nerve endings of trigeminal nerve are located. This provides good relief, as I have seen in about 10 patients. Some other neurologists have also observed this.
You should note that botox is not FDA approved for trigeminal neuralgia, however, it is approved for a host of other painful conditions, including migraine headaches.
Doing second microvascular decompression is not an option now, as it is technically very demanding, and very few surgeons can do the second surgery well.
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, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for such a fast response.
I am planning to visit XXXXXXX in January 2015 and would like to know if you perform the surgery and if yes how much? Your success rate? How long is the recovery time?
Thank you,
XXXX
I am planning to visit XXXXXXX in January 2015 and would like to know if you perform the surgery and if yes how much? Your success rate? How long is the recovery time?
Thank you,
XXXX
Brief Answer:
I am a Neurologist.
Detailed Answer:
Thank you for getting back.
I am a neurologist and I treat trigeminal neuralgia with medications and I also give botox injections.
The MVD surgery and RF ablation are done by my neurosurgeon colleagues Dr XXXXXXX Ranjan/Dr XXXXXXX Lath. I can put you in touch with them over email. Please send an email to me asking the same questions regarding the surgery.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
I am a Neurologist.
Detailed Answer:
Thank you for getting back.
I am a neurologist and I treat trigeminal neuralgia with medications and I also give botox injections.
The MVD surgery and RF ablation are done by my neurosurgeon colleagues Dr XXXXXXX Ranjan/Dr XXXXXXX Lath. I can put you in touch with them over email. Please send an email to me asking the same questions regarding the surgery.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good morning Dr XXXXXXX
We would like to know how long the Botox injections last? Side effects?
Thank you,
XXXX
We would like to know how long the Botox injections last? Side effects?
Thank you,
XXXX
Brief Answer:
Botox injections are safe.
Detailed Answer:
Thank you for getting back.
Botox injections are safe and the effect lasts for about 3-6 months.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Botox injections are safe.
Detailed Answer:
Thank you for getting back.
Botox injections are safe and the effect lasts for about 3-6 months.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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