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Treatment options for permanent relief from pain due to trigeminal neuralgia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   hi
Doctor :   Dr.XXX here
Doctor :   please proceed with your health query
Doctor :   how can I help you?
User :   helo dr gd mrning , i hv already sent query , . the patient is suffering from trigminal neuralgia, should i rpt the queries i hv already sent?
Doctor :   I am sorry I did nor receive your queries. Please type it in the chat window.
Doctor :   what are his current symptoms?
Doctor :   how old is the patient?
User :   ok tks, the patient is suffering from trigminal neuralgia since last 19 months and medication since then, patient is allergic to carbamazpine and had to be hospitalised at cmc vellore for
User :   drug reaction, all mri/ tests done, presntly flwg medicine is being administerd,
User :   gabapine 300 x 2 caps 2 times and gabapine 300 x 3 times at night,
Doctor :   ok
User :   tryptomer25 mg x 2 2 times a day.
User :   zintac 2 tbs daily amyxide-h 2 times was also given but stopped now,
Doctor :   ok
User :   presntly patient is is having difficulty is having food(food is made in to paste and then with spoon, food is fed slowly), while talking also pain is there.
Doctor :   ok. how old is the patient?
User :   brushing teeth also having pain. rr
Doctor :   does he have any other past medical illness? if yes please provide details of treatment.
Doctor :   hi
Doctor :   are you there?
User :   sorry , was disconncted, the patient is female 53 yrs old, may be around 10/12 yrs ago, she used to hv fever/cough/cold etc persistenly but now it is ok. in the yr 1978-80 she suffered from tb but recurrence after wards,, she was treated for vitilago but is ok now,
Doctor :   please proceed
Doctor :   the symptoms at present do suggest that the trigeminal neuralgia is not yet controlled
Doctor :   the atypical symptoms like the pain with swallowing and brushing she is having could be related to the trigeminal neuralgia itself
User :   she was having tb 1978 -80 was cured and no recurrence afterwards, was suffering from spondilytis in 1987-89 but its ok now
User :   kindly suggest remedy for trigminal neuralgia and pain relief pls..
Doctor :   the permanent solution and long term benefits are known to be with botox injections, and gamma knife therapy and radiation
Doctor :   you can discuss about these treatment options with the treating neurosurgeon
Doctor :   and see if either of these can be done for her
User :   can u pls tell me abt side effects of botox injection /gama knife surgery pls
User :   also can u suggest some medicine to control the pain but having no carbamazapine component
Doctor :   side effects of botox include facial pain, swelling, flu symptoms, respiratory infections, eye lid drooping, headache etc
Doctor :   gamma knife therapy is teh latest advancement in treatment
Doctor :   and it is predicted to give long lasting benefits with minimal side effects
Doctor :   since teh pain is neurologic in nature, common painkillers usually do not work effectively
User :   also i was advised for x-knife surgery, can u suggest the effectiveness of x-knife surgery,
Doctor :   you can request her treating doctor to increase the dose of antidepressant (Tryptomer) to see if she gets benefitted
Doctor :   it is the similar to gamma knife surgery, and it is effective
User :   because at XXXthere is no gama knife surgery facility, but x-knife facility is there
Doctor :   you can go ahead with it for having long term pain relief
User :   dr where are based at pls.
Doctor :   I am based in Bangalore.
Doctor :   you can go ahead with treatment in XXX or if possible get the patient to XXXfor further treatment
User :   any suggestion for medicine to relieve pain
Doctor :   as I said earlier, since the pain is neurologic in nature, common painkillers usually do not work effectively. you can request her treating doctor to increase the dose of Tryptomer to see if she gets benefited
User :   dr where in XXX gama knife treatment is given and any idea of expences for gama knife surgery
Doctor :   you need to discuss it in the institution you would like to have the surgery done
User :   i do not know which institution at XXX this facility is available
Doctor :   you can contact XXX for further management
User :   ok tks dr for yr valauable suggestions but dr can u pls advise me whether to gor for
User :   x-knife surgery at XXX or gama knife atXXX
Doctor :   you can go ahead with either of them as per your convenience. both have similar cure rates
User :   ok tks dr c u ltr bi bi
Doctor :   is there anything else I can help you with?
User :   u can help by suggesting by saying emphatic "yes" go ahead with x-knife at XXXif u say its good
Doctor :   yes, x-knife surgery is known to have similar cure rates. Gamma knife treatment is the latest advancement. You can go ahead with treatment inXXX itself under proper guidance and supervision.
User :   thank you dr XXXXXXXX will c u ltr bi bi
Doctor :   thanks for consulting me. bye for now.
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