Author: Dr. Jaydev Panchwagh

Trigeminal Neuralgia Awareness Day

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On the occasion of Trigeminal Neuralgia Awareness Day, Dr Jaydev Panchwagh says: “Trigeminal Neuralgia  is an often misunderstood disease, especially in the early phase, when a diagnosis is not established. It is characterised by severe facial pain that is agonising enough to warrant thoughts of self-harm. It is therefore known as ‘ Suicide Disease'”. He an eminent Neurosurgeon in the city of Pune and an internationally acclaimed specialist in MVD surgery, for Trigeminal Neuralgia and Hemifacial Spasms.

Dr Jaydev Panchwagh, Neurosurgeon, MVD surgery specialist on Trigeminal Neuralgia Awareness Day
Dr Jaydev Panchwagh, Director, Centre of Excellence for MVD Surgery, Pune, India

In this article written by Dr Jaydev Panchwagh on the same subject, he has discussed various aspects of this deadly disease.

Trigeminal Neuralgia Awareness Day

October 7th is known as World Trigeminal Neuralgia Day. In fact, the entire month of October is recognised as Trigeminal Neuralgia Awareness Month. On this occasion, Dr Jaydev Panchwagh has actively organised many seminars, public education lectures, interactions and also written a book that will be published shortly.

Medication is generally the mainstay in treatment of Trigeminal Neuralgia. But there are other options including a surgical one. A promising option that has the greatest potential to permanently cure it is MicroVascular Decompression Surgery (MVD Surgery). 

This is what he has to say:

You can also listen to the experience of many patients in this talk as well.

Trigeminal Neuralgia-some facts

Trigeminal Neuralgia is a neurological condition that causes severe facial pain. Unfortunately, it is often misdiagnosed due to its rarity and similarity to other conditions. This is why raising awareness about Trigeminal Neuralgia is so important. Here are some facts about this condition that you may find interesting:

  • Trigeminal Neuralgia affects the trigeminal nerve, which is responsible for transmitting sensations from the face to the brain.
  • The pain caused by Trigeminal Neuralgia is often described as a sharp, stabbing sensation that can last for several seconds or minutes.
  • The pain can be triggered by simple activities such as chewing, talking, or even brushing your teeth.
  • Trigeminal Neuralgia is more common in women than men and typically affects people over the age of 50.
  • There are several treatment options available for Trigeminal Neuralgia, including medication, surgery, and alternative therapies such as acupuncture and chiropractic care.
  • Despite these treatments, many people with Trigeminal Neuralgia continue to experience chronic pain and may require ongoing management of their symptoms.
  • Trigeminal Neuralgia Awareness Day on October 7th is an opportunity to educate the public about this condition and advocate for improved access to care and support for those affected by it.

If you or someone you know is experiencing facial pain that may be caused by Trigeminal Neuralgia, it is important to seek medical attention and receive a proper diagnosis. With proper treatment and support, it is possible to manage the symptoms of this condition and improve quality of life.

Dr Jaydev Panchwagh on Knowledge, Spirituality and Brain

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Dr Jaydev Panchawagh, renowned Neurosurgeon in Pune writes…

Dr Jaydev Panchawagh neurosurgeon in Pune writes on Knowledge, Spirituality and brain. This is an article published in Sakaal newspaper on 20th September 2023, on the auspicious occasion of Ganesh Chaturthi, the Lord of Knowledge and Wisdom. Sakaal 20th September 2023, page 7.

Dr Jaydev is a specialist in brain and spine surgery. His passion is MVD surgery for the treatment of Trigeminal Neuralgia, Hemifacial spasm and Glossopharyngeal neuralgia.

Surgical Treatment for Trigeminal Neuralgia ..a complex situation!

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Surgical treatment of Trigeminal Neuralgia by MVD surgery is a fairly straightforward one; but if it is complicated by a cerebellar AVM, there are many twists and turns that could potentially be serious.

 

Dr Jaydev Panchwagh best Neurosurgeon

 

https://timesofindia.indiatimes.com/city/pune/complex-neurosurgery-at-city-hospital-rids-malawi-woman-of-excruciating-pain/articleshow/101324489.cms

A rare and technically challenging Brain surgery performed by Dr Jaydev Panchawagh and his team gives a new lease of pain-free life to African woman at Pune.

Arterio-Venous-Malformations (AVM)

AVMs occurring inside the brain are formidable Neurosurgical challenges.

What is an AVM?

An AVM is an area of a densely packed conglomerate of malformed blood vessels. Normally an artery supplying a particular part of brain divides into smaller ‘arterioles’ and then even smaller ‘capillaries’. These smaller vessels have a strong muscular coat in their walls so that they can shrink in diameter to allow the blood flow in brain tissue to be slow and steady for the oxygen delivery to happen effectively.
The used blood is then collected by draining veins which open into bigger venous channels to take it to lungs eventually.

Why is an AVM dangerous?

In an AVM, not only are the vessels malformed, but the muscular layer in the smaller capillaries is absent, making them unable to contract. Also the smaller capillary layer is often absent. This causes direct shunting of arterial blood to the veins at very high speeds and flow rates.
AVMs in the brain are even more formidable as they occur in very important areas and their removal is considered one of the most difficult of brain surgeries…..which are , as a group challenging in the first place.
Secondly, brain being the most prized organ for the body, it’s blood flow follows slightly different rules than the remainder of the body. “Blood brain barrier” and “Cerebral blood flow Autoregulation” are only two examples of its (brain’s) unique nature.
Some of these unique characteristics could also be absent in AVMs, making them difficult to be tamed by surgery.
Another problem with the AVM is a “steal” phenomenon. As the name suggests, due to a very high flow across the AVM and reduced resistance for the flow in this area, some of the blood supply of the surrounding brain is “stolen” by the AVM.
The blood vessels which lead to the AVM, though not directly taking a part in formation of the AVM, increase in diameter, become tortuous and thicken due to continuous higher blood stream flowing through them.

Is AVM dangerous?

Brain AVMs can present with sudden bleeding or fits.
AVMs presenting with compression of the nerves causing neuralgia though known is extremely rare.

Details of this rare case….intolerable Face pain

In the rarest of rare, and surgically challenging case, a 54 year old eastern African patient was treated by combination therapy of Angiography led Embolization followed by Brain surgery to remove the malformation completely.
She was suffering from severe pain in the distribution of Trigeminal nerve and Glossopharyngeal Nerve for last many years.
The pain became intolerable even on very high doses of medicines.

Trigeminal Neuralgia and Glossopharyngeal Neuralgia in same patient

For her double Neuralgia, (Trigeminal Neuralgia and Glossopharyngeal Neuralgia) she came to the MVD surgery Centre at Pune.
But in her case, a simple MVD surgery would not have been sufficient as a more formidable problem in the form of Cerebellar AVM was present in the same area as the nerves.
In fact, the nerves were getting compressed due to high engorged blood vessels supplying the AVM.
Thus it was a much complex problem.
The treatment was planned with a detailed planning sessions with Neurosurgeon Dr Jaydev Panchwagh and interventional vascular specialist Dr Alurkar.
“This was rarest of the rare case, as we had to not only relieve her of extreme pain but while doing it, needed to eliminate the AVM completely.”

Staged operation

In the first stage, AVM was partly occluded by Angiography guided intervention technique.
In this a very thin catheter is inserted in the blood vessels supplying the AVM and medical glue is injected into the vessels.
This glue flows forward a bit and immediately becomes hard, this occluding the AVM blood vessels.
“However, we have to be careful as, if even a small excess amount is injected, it could occlude normal blood vessels or it can flow in normal circulation causing obstruction at undesired sites”
“Also due to tortuosity and curvaceous nature of AVM vessels, some of the vessels may not be approachable for threading the catheter.”
Therefore, after safe embolization, the AVM needs to be removed to ensure instant cessation of bleeding risk.”
“AVM surgery needs skilled operator and has to be done with meticulous planning and with the most modern Neurosurgical equipment.
After embolization, this AVM was still getting blood supply from multiple arteries and was in the cerebellum.
During the surgery, we have to be very careful to separate very important blood vessels which are “passing'” next to the AVM but not supplying it. They are the “transiting vessels” they need to be preserved.
Also, the actual feeding vessels are high flow vessels and need secure clipping before cutting them.
After 8 hour long meticulous surgery, we had to do the most important part.
That was to separate the blood vessels compressing the trigeminal and Glossopharyngeal nerves to treat her pain of Trigeminal and Glossopharyngeal double neuralgia.”

What is MVD surgery?

MVD surgery is a brain surgery during which the affected nerve..in this case the Trigeminal nerve and  glossopharyngeal nerve is made free of compression from the offending blood vessel by using a piece of teflon pad. In experienced hands it has low risk.

Dr Jaydev Panchwagh

Dr Jaydev Panchwagh is an eminent neurosurgeon in India. He is based out of Pune. He is the Director of Centre of excellence for MVD surgery, at Pune. He has performed more than 2000 MVD surgeries for Trigeminal neuralgia and glossopharyngeal neuralgia.

Medicines for face pain

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Medicines for face pain treatment

Medicines for face pain treatment are generally those that are used to treat fits (convulsions, seizures). These come under the group called anti-convulsants (these numb the brain and prevent response to stimuli). Anti-convulsants are medicines used to control convulsions(or “fits”).

While there are many medicines that could be used, some are similar to the older versions, some are very different; and some medicines are not related at all. Acupressure, acupuncture, Ayurveda and Homeopathy have also been tried.

How do medicines act?

Basically, all act by numbing the brain (Central nervous system ). The intention is to reduce reactivity of the Trigeminal nerve, but no medicine can act on just one nerve. It therefore acts on the entire nervous system, numbing it. This is the primary reason for the major side-effects of medication.

So, for most people, medication is the first line of treatment. Most of them are off-label  for the treatment of facial pain (Trigeminal Neuralgia). Most patients need to adjust the medication with varying combinations and dosages to get the best pain relief effect with minimal side-effects.

The following video describes the typical journey of a patient who has started having facial pain on one side of the face:

Which medicines are commonly used to treat face pain?

Among the medicines that are used for treatment of trigeminal neuralgia and face pain are

Carbamazepine/Oxcarbamazepine/Eslicarbamazepine,

Gabapentin/Pregabalin,

Phenytoin and other anti-convulsants,

Some anti-depressants,

Skeletal muscle relaxants,

Anaesthetics

Toxins.

These medicines have different formulations and trade names.

How are medicines to treat TN pain started?

Initially only one drug is generally started, at a small dose, then the dose is increased as necessary. If the pain continues to increase in intensity and frequency, a second or third drug may be added. Please be sure to talk to your doctor about the effect and side-effects that you experience. Please look out for rashes or itching or some other sign that you maybe allergic to the drug.

Are there any specific drugs for TN pain?

There is a new drug that is being developed specifically for trigeminal neuralgia pain. Research is still on, and it is in the planning stage.

Please be sure to talk to your doctor about the effect and side-effects that you experience.

What are the side-effects of medicines used to treat face pain?

Common side effects of Medicines used for treatment of facial pain:

Memory loss

Reduced co-ordination

Confusion

Weight gain

Loss of balance

Drowsiness

Difficulty in finding the right words

Fatigue

Irritability

Dry Mouth

Nausea etc

Can these drugs be stopped suddenly?

No. Stopping the medicines used to treat your TN pain is as challenging as starting you on them.

Because of the need to titrate your dosages, or shift to a different medication you need to know this.

We need to change dosage or type of medicine if you are not responding,   nature of pain has changed. a nerve block injection has failed or pain has recurred.

Typically, the medicines in high doses are tapered off over few weeks before stopping completely. This is especially true after you have undergone a successful MVD surgery. Dr Jaydev Panchwagh and his team have a specific protocol for tapering these drugs.

So, what can be expected during withdrawal?

Typically, one notices dizziness, nausea, increased pain, agitation, confusion, disorientation, violent dreams, tremors, irritability etc

Where can I find more information on the medicines?

We have an entire website dedicated to treatment of Trigeminal neuralgia pain. You can find information here.

Is there any alternative to medicines?

Yes, people try naturopathy, Homeopathy, Ayurveda, or Acupuncture, Acupressure and others.

Some people believe exercises help them. Some make adjustments in food.

What if medicines for treating the pain of trigeminal neuralgia have stopped working?

Do not worry! There are alternative treatments available. Nerve injections and Gamma knife procedures are nerve destructive procedures. Their effect is generally temporary. The success rate for pain relief is also less as compared to surgery.

Surgery for TN is called Microvascular Decompression (MVD surgery). It is generally a nerve preserving procedure, offers the potential of permanent pain relief. You can learn more about this here and here.

Dr Jaydev Panchwagh is the chief Neurosurgeon and Director of the Centre of excellence for MVD surgery in Pune, India. He has been keenly focused on MVD surgery for nearly twenty years and has operated on patients from more than 22 states in India, and about 13 countries around the world. He has performed more than 1900 MVD surgeries as of this date.

You can find more information on his work here.

Trigeminal neuralgia symptoms

कान और गले में दर्द

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कान और गले में दर्द होना, विशेष रूप से निगलने पर दर्द होना Trigeminal Neuralgia का संकेत (indicator) हो सकता है.

अधिक जानकारी के लिए, इन  विडियो जरूर  देखें. Glossopharyngeal Neuralgia.

Trigeminal neuralgia के लक्षण क्या है?

गाल में दर्द, जबड़ों में दर्द, दांतों में दर्द, या निगलते समय दर्द ….ये सब Trigeminal Neuralgia के लक्षण हो सकते हैं.

चेहरे की नसो में दर्द को ट्राइजेमिनल न्यूराल्जिया कहते हैं।

Trigeminal neuralgia क्या है?

चेहरे की नसो में दर्द का नाम ट्राइजेमिनल न्यूराल्जिया है. चेहरे के दर्द के कई कारण होते हैं. सबसे आम कारण ट्राइजेमिनल तंत्रिका को संकुचित करने वाली रक्त वाहिका है. (Nerve और blood vessel के बीच  compression). Trigeminal neuralgia का दर्द कैसा रहता है? trigeminal neuralgia का दर्द बहुत ही भयानक और असहनीय होता है. कभी बिजली जैसा दर्द, तो कभी चुरी चुभो रहा हो ..इस जैसा…कई प्रकार है.

चेहरे की नसो में दर्द क्यों होता है?

चेहरे का दर्द ट्राइजेमिनल तंत्रिका के संपीड़न के कारण होता है.

चेहरे की नसो में दर्द का इलाज क्या है?

चेहरे की नसो में दर्द का इलाज, पहले दवाई से की जाति है. अगर दर्द कम नहीं हुआ तो एमवीडी सर्जरी (MVD surgery) कर सकते हैं.

कान और गले में दर्द अगर trigeminal neuralgia के वजह से है तो उसका इलाज हो सकता है. पहले दवाइयों से, फिर सर्जरी से. इस सर्जरी का नाम है मिक्रोवास्कुलर डीकम्प्रेशन सर्जरी. इसके बारे में और जानकारी के लिए हमारे  Youtube चैनल देखें.

डॉ जयदेव पंचवाघ ब्रेन और स्पाइन सर्जन हैं जो इस MVD operation करने में काफी अनुभवी हैं. 

 

Microvascular Decompression Surgery

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Microvascular Decompression Surgery or MVD surgery is a brain operation, commonly done to relieve nerve compression of the fifth (Trigeminal nerve) and seventh (Facial Nerve) cranial nerves. Occasionally the ninth (Glossopharyngeal nerve nerve is also decompressed by itself or in conjunction with the Trigeminal nerve. Cranial Nerves are nerves that arise in the brain. They are twelve in number.

All about MicroVascular Decompression:

 

What is MVD surgery?

There are twelve nerves that arise from the brain, on each side. Of these, the fifth (Trigeminal nerve), seventh-eighth complex(Facial-Vestibulocochlear) and ninth(glossopharyngeal) nerves are prone to compression leading to hyperactivity disorders that need treatment.

What is the fifth nerve called?

The fifth cranial nerve is the Trigeminal Nerve. The Trigeminal nerve supplies the sensation to the face. It has three divisions : V1,V2 and V3. these supply specific areas of the face on each side.

What is the seventh-eighth nerve called?

The seventh-eighth cranial nerve complex is the Facial nerve-Vestibulocochlear nerve complex. The facial nerve supplies the facial muscles. The eighth nerve is the nerve of hearing and balance. This is the reason why in Hemifacial spasm, occasionally, either tinnitus or a clicking sound may be heard.

What is the ninth nerve called?

The ninth nerve is the Glossopharyngeal Nerve. It supplies sensation to base of tongue, tonsillar pillars and throat. There are other functions too, but this is the function most affected in glossopharyngeal neuralgia and causes pain while swallowing.

What is Microvascular Decompression surgery?

It is an operation done at the level of the brainstem, where the involved nerve exits/enters the brainstem. The blood vessel compressing the nerve is moved away from the nerve(decompressed) using a microscope/ endoscope or both. This is performed to treat Trigeminal neuralgia, Hemifacial spasm or glossopharyngeal neuralgia.

Is it possible to see a video of MVD surgery?

Certainly. Dr. Jaydev Panchwagh, chief Neurosurgeon and Director at the MVD Centre shows us how it is done. here:

If you are interested in knowing more about a video discussing diagnosis, symptoms, MRI and treatment, please click here.

Can I get a comprehensive idea about Trigeminal neuralgia?

Yes, you can read all about it on this page.

चेहरे की नसो में दर्द

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चेहरे की नसो में दर्द क्या कहलाता है?

चेहरे की नसो में दर्द का नाम ट्राइजेमिनल न्यूराल्जिया है।

Trigeminal neuralgia का दर्द कैसा रहता है? trigeminal neuralgia का दर्द बहुत ही भयानक और असहनीय होता है. कभी बिजली जैसा दर्द, तो कभी चुरी चुभो रहा हो ..इस जैसा…कई प्रकार है.

इसके कई कारण होते हैं । सबसे आम कारण ट्राइजेमिनल तंत्रिका को संकुचित करने वाली रक्त वाहिका है ।

शुरू में इस बीमारी को ठीक करने के लिए दवाइयां दी जाती है..जैसे की Tegretol, Mazetol या Carbamazepine.

दर्द का वजह नस का कम्प्रेशन होता है. यह MVD surgery से ठीक हो सकता है.

ट्राइजेमिनल न्यूराल्जिया  क्यों होता है?

चेहरे का दर्द ट्राइजेमिनल तंत्रिका के संपीड़न के कारण होता है । चेहरे की नस को Trigeminal Nerve नाम  से जाना जाता है. इस तंत्रिका के तीन भाग होते हैं, जो चेहरे के ऊपरी, मध्य और निचले हिस्से को सप्लाई करते हैं.

चेहरे में दर्द , एक दुर्लभ nerve का विकार है। यह चेहरे के गंभीर दर्द का कारण बनता है.

Trigeminal nerve distribution
(pic courtesy: Wikicommons)

 

गाल में दर्द या जबड़ा में दर्द ट्राइजेमिनल न्यूराल्जिया के कारण भी हो सकता है। Neuralgia याने नस में दर्द होना. इसी लिए इस नस के दर्द के बीमारी को {चेहरे की नसो में दर्द) trigeminal neuralgia बोलते हैं.

चेहरे  की नसो में दर्द (trigeminal neuralgia) का इलाज क्या है?

चेहरे की नसो में दर्द का इलाज, पहले दवाई से की जाति है। अगर दर्द कम नहीं हुआ तो एमवीडी (MVD) सर्जरी कर सकते हैं। यह ऑपरेशन न्यूरोसर्जन करते हैं.

ट्राइजेमिनल न्यूराल्जिया का दर्द कैसा होता है?

रोगी को तेज बिजली की तरह का झटका लगता है जैसे आंख, गाल, मसूड़े या जबड़े में बिजली का दर्द ।

क्या यह कान के दर्द के रूप में भी उपस्थित हो सकता है?

हां। TN भी कान में दर्द पैदा कर सकता है; लेकिन यह ग्लोसोफेरींजल न्यूराल्जिया से भी जुड़ा हो सकता है।
यदि आप ट्राइजेमिनल न्यूराल्जिया के बारे में अधिक जानना चाहते हैं, तो कृपया इस वीडियो पर क्लिक करें ।
 
Dr. जयदेव पंचवाघ न्यूरोसर्जन हैं । वह पुणे में एमवीडी सेंटर के निदेशक (डाइरेक्टर) हैं ।

उनका अनुभव बहुत विशाल है । उन्होंने अब तक 1850 से अधिक MVD सर्जरी की हैं.

अगर आप इसका इलाज के बारे जानना चाहते हैं, तो यह विडियो आपको उपयुक्त होगा…

 

 

Is MVD surgery risky?

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Is MVD surgery risky?

This is a transcript of an interview with Dr Jaydev Panchwagh, neurosurgeon. This was aired on TV. He is the Director of the MVD Centre in Pune.

Trigeminal Neuralgia: General Information

Interviewer: Doctor, I read up some articles on Trigeminal Neuralgia before this interview. It appears that the patients are affected by a very severe kind of pain in the face.

Dr Jaydev Panchawagh: Yes!! The pain is so severe and comes so suddenly that some patients even contemplate suicide!! The pain is variously described as sharp, stabbing, burning, shock-like etc.

Trigeminal Neuralgia: Treatment choices

Interviewer: I also read that there are many kinds of treatments available, but none really effective. Is that correct?

Dr Jaydev Panchawagh: Treatment of Trigeminal neuralgia is usually started with medicines (tegretol, Carbamazepine). Initially they are effective. But over a period of time, the pain takes over. We need to increase medicine doses. The pain gets controlled. Then over the next few months, medicines lose their effectiveness. The doses need to be further increased or medicines changed. This goes on till the pain becomes unbearable or the medicine’s side effects are not tolerated. The patient then has to consider other options. But in our MVD Centre, we often give the option of surgery before very high doses of medicines are reached. Because, the side effects are at this time unacceptable.

There are other treatment options like RFLG,  nerve Blocks ,  balloon compression , or Gamma knife radiation but my particular preference has generally always been MVD surgery.

Trigeminal Neuralgia: MVD surgery

Interviewer: So, is MVD surgery a brain surgery?

Dr Jaydev Panchawagh: Yes, MVD or MicroVascular Decompression surgery is a brain surgery. The operation is performed where the Trigeminal nerve exits from the brainstem. It is in a very deep part of the brain.

Interviewer: Is MVD surgery risky?

Dr Jaydev Panchawagh: It is fairly safe in the hands of an experienced surgeon. The more MVD surgeries one performs, the more comfortable one becomes with the anatomy there. We become more aware of what to expect, what to do, what not to do. So the chances of success in the surgery also is much higher than in the hands of an inexperienced surgeon. This is one of the reasons why MVD surgery is best done at Centres which have a high volume of these surgeries. 

Why experienced neurosurgeon matters?

The patient must therefore find out how many such surgeries the surgeon has performed. The potential risks could be infection, bleeding, hearing loss, facial numbness, and/or facial weakness (generally temporary),  CSF leak, difficulty to talk/ swallow, stroke/ paralysis/risk to life (extremely rare).

Interviewer: Doctor, how many MVD surgeries have you performed so far?

Dr Jaydev Panchawagh: I have performed more than 1600 surgeries so far (from 2002 to 2022). You can access the testimonials of some of the patients here.

Interviewer: What is the aim of MVD surgery?

Dr Jaydev Panchawagh: The final goal is to prevent pain that arises because of compression of the Trigeminal Nerve either by a blood vessel or by brain tumors.

Interviewer: Is MVD performed for treatment of Trigeminal neuralgia alone?

Dr Jaydev Panchawagh: No, MVD can be performed for treatment of Hemifacial spasm ( affecting the Facial nerve) or Glossopharyngeal Neuralgia(affecting the glossopharyngeal nerve). You can know more about this in my video explaining Hemifacial spasm symptoms and causes.

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You may watch this video to know more about Glossopharyngeal neuralgia .

 

What is Trigeminal neuralgia?

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What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic facial pain caused by a hyperactivity disorder of the Trigeminal nerve. In simple words, it is a symptom of Trigeminal nerve compression. This compression could be caused by a blood vessel or by a tumor, among many other causes. TN  pain is severe and is generally treated with medicines, initially.

What is the trigeminal nerve?

Trigeminal nerve is the fifth nerve which is given off from the brain. It is a cranial nerve. This is a sensory as well as motor nerve. It means that the nerve supplies sensation to the face and the motor component supplies muscles of chewing.

What is the commonest presentation of trigeminal neuralgia?

Commonly TN pain begins after some form of dental treatment, either an extraction or root canal work. However, the dental work actually is only a trigger, not the cause. Other triggers for the trigeminal neuralgia pain are brushing, eating, talking, shaving, touching etc.

Can Trigeminal neuralgia be associated with ear pain?

Yes. TN itself can cause ear pain; but it may also be associated with Glossopharyngeal neuralgia which can also be the cause of ear pain.

How is the pain of Trigeminal neuralgia?

The patient has severe electric shock like or lightning like pain in the eye, cheek, gums or jaws. Mostly, this disorder is diagnosed late. Thus the patient suffers for many years before they are told their diagnosis. It is frequently mistaken for migraine, dental pain or ear pain. MRI is performed to support the clinical diagnosis.

Can MVD be done after RFLG?

Yes, but a primary MVD always gives better success. Radio Frequency Lesioning or ablation of the trigeminal nerve is a destructive procedure. MVD surgery is a nerve-preserving procedure.

Who performs the MVD surgery?

MicroVascular Decompression (MVD) surgery is a brain surgery and is performed by a neurosurgeon. An experienced neurosurgeon gives the best results, better success rates and lower chances of risks.

Can we get any patient testimonials or their experiences?

Sure. Please click here to read and watch videos of patient experiences. All these patients have been operated by our team, at the MVD Centre. You can click here to read more Frequently Asked Questions on Trigeminal neuralgia and MVD surgery. You can visit the home page of this website on trigeminal neuralgia treatment by clicking here.

Who runs the MVD Centre?

The MVD centre is in Pune. The Director is Dr Jaydev Panchwagh, who has an experience of more than 30 years in the field of neurosurgery. His passion in the specialty is MVD surgery.

 

Symptoms of Trigeminal neuralgia

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Symptoms of trigeminal Neuralgia:

Symptoms of trigeminal Neuralgia are generally electric shock-like pain in the face. This could be in the forehead, eye, cheek, nose, upper or lower jaw areas.

What are the triggers for face pain or trigeminal neuralgia?

Typically the triggers that set off an episode of Facial pain are touching, brushing, shaving, chewing and talking.

 

 

How does an attack of Trigeminal Neuralgia look like?

This pain is so severe and horrible that it is called the suicide disease! Watch this video to see how the TN attack looks.

Can Trigeminal neuralgia pain be treated ?

The good news is, Yes!!  Though medical treatment is the mainstay, especially in the initial phases of the disease, medicines soon become ineffective. Occasionally, the patient has a pain holiday and comes to believe that his/her pain has been cured. But it comes back with a vengeance, and this is the time that most patients usually seek permanent treatment.

Do I need to visit a neurologist or neurosurgeon to treat Trigeminal Neuralgia?

Initially, after the diagnosis of Trigeminal neuralgia is made, the patient is referred to a neurologist, to start medical therapy. The neurologist adjusts the doses as necessary, and helps the patient understand how to time the doses to get best pain relief. The neurosurgeon is involved when the patient no longer finds medication useful, or when the side-effects of medicines are unbearable. The neurosurgeon then offers Microvascular Decompression surgery as a possible permanent treatment.

Is Dr Jaydev Panchwagh an MVD Specialist?

Yes. Dr Jaydev Panchwagh is a neurosurgeon practising in Pune, Maharashtra. He is passionate about treating Trigeminal neuralgia and Glossopharyngeal Neuralgia. With the aim of focusing on the treatment of this deadly pain, he has been instrumental in putting together a dedicated team. He is the Founder-Director of the Centre Of Excellence for MVD surgery. It is perhaps the only one of its kind in India.