best treatment of trigeminal neuralgia Archives | Trigeminal Neuralgia Treatment

Is MVD surgery risky?

Posted on February 23, 2022 | by Dr. Jaydev Panchwagh | 3 Comments

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.

“

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

Microvascular decompression for TN

Posted on May 7, 2021 | by Dr. Jaydev Panchwagh | 1 Comment

Microvascular decompression for TN is a potentially curative surgery and can be a permanent solution.

In this video on treatment of Trigeminal neuralgia with Microvascular decompression surgery, a patient shares his experience 2 years later. Many questions like What is the main cause of Trigeminal neuralgia? and what is the best treatment of trigeminal neuralgia are answered. Do watch the entire video for all the answers.

He says “The pain of Trigeminal neuralgia was severe enough to contemplate suicide. It started suddenly, without warning, electric shock-like. And when I got the TN attacks, people around me would wonder what happened to me so suddenly? Medical treatment made me have memory loss and loss of balance. And it also made me very drowsy and numb. The medicines stopped having effect on my pain later on. Only the side-effects persisted because I was increasing my doses to get pain relief from my facial pain attacks.”

MVD surgery for Trigeminal neuralgia

Microvascular Decompression for TN is one of the many procedures that can be done to cure the pain of Trigeminal Neuralgia. However, this is the only possibly permanent treatment. The highest rate of success is in experienced hands. In this surgery a teflon piece is inserted between the blood vessel(s) and nerve to prevent compression.

You can listen to other patient experiences here:

Dr Jaydev Panchwagh is the founder-Director of the MVD Centre in Pune. He is a well-established neurosurgeon of national and international repute. He is also founder-member of Synapse brain and Spine Foundation.

Pain relief after MVD operation

Posted on April 9, 2021 | by Dr. Jaydev Panchwagh | 6 Comments

Pain relief after MVD operation: How long does it last?

It is generally permanent or at least very long-lasting.

Here is the experience through a video testimonial of two patients who underwent Microvascular Decompression surgery or MVD operation in 2017. This video was recorded 3 years after their surgery.

What are the aims of MVD operation?

Pain relief is the primary aim after MVD operation. Reducing or complete cessation of medication is a secondary benefit.

What kind of pain relief may be expected after MVD operation?

The pain of Trigeminal neuralgia is generally electric-shock like and is episodic, brought on by trigger factors. The relief after a successful MVD operation is immediate, and complete.

This means that the patient will now not experience any trigger factors. He/she is able to eat, talk, brush teeth, wipe face, shave, apply make-up etc. without experiencing facial pain. Sometimes after MVD surgery, there may be a temporary facial numbness as the trigeminal nerve is healing itself from the pre-operative short-circuiting.

What are some of the FAQs regarding Trigeminal neuralgia or MVD operation?

There are plenty of questions and you will find the answers here.

Who performs the MVD operation at the MVD Centre, Pune?

Dr Jaydev Panchwagh is the neurosurgeon (brain surgeon) who performs all MVD operations in the MVD Centre in Pune.

A single-surgeon experience of more than 1380 surgeries is phenomenal, considering that this disease is not very common.

Where can I read more about other patient experiences at the MVD Centre in Pune?

There is a support group, which you can get in touch with if you contact us. We can link you up with other patients or share their testimonials.

Where is Pune?

Pune is a big, thriving city about 100 kilometers from Mumbai. It is well-connected by airports and trains. It has multi cuisine restaurants, and is very cosmopolitan.

There are plenty of international students in Pune, which is also considered an educational hub in India. International medical tourism is also popular in this city.

Trigeminal neuralgia medication-how to take them?

Posted on September 19, 2020 | by Dr. Jaydev Panchwagh | 50 Comments

Trigeminal neuralgia medication, at least the majority of them, are anti-convulsants.

“How to take them-Trigeminal neuralgia medication?”

Can I take TN medication when I feel the pain coming on?

Can I add more drugs during a Trigeminal neuralgia attack?

Do I have to continue taking the Trigeminal neuralgia medicines even if I have no or minimal pain?

These are all questions that frequently come to the patients’ minds.

What is essential to understand is that TN medicines are not straight-forward pain-killers. They are primarily anti-convulsants or brain numbing medications. Once the first pill is consumed, it takes a few hours to reach the blood. The liver simultaneously metabolizes the drug, while some of it also reaches the brain to act upon. So in effect, the blood level reduces. Over a period of the next few hours, the blood level will become zero. Before this happens, we need to consume another pill to increase and maintain the blood level. If this does not happen, there is no effect on the pain as well.

In short, regular medication is essential to maintain a particular blood level of the drug, so that it calms the brain/ nerve. This calming effect means that they do not respond to pain signals, and therefore have a neuralgic-pain-reducing effect.

Another key point to be noted is that the dosages need to be very gradually increased (and decreased also).

What happens if I take too many TN pills?

Well, you will certainly start manifesting all the side-effects of these anti-convulsants, like drowsiness, dizziness, imbalance, mental clouding, memory loss, depression etc. This is why, their dosages have to be adjusted by your doctor, who will determine what is right for you. One typically starts with the lowest dosage twice or thrice a day. This may be increased to maximum doses four times a day.

What happens if I miss a couple of doses of TN medication?

The blood level reduces, and you may experience break-through pain.

Allergic reactions to Trigeminal neuralgia medication

When starting off drugs to control TN pain for the first time, one has to be aware of and be on the lookout for allergic reactions. Though rare, it is not unheard of. I have come across a few patients in my practice. Typically they are in the form of skin rashes. These may be the harbinger of a very serious and potentially fatal Stevens-Johnson syndrome. If one notices skin rashes on consuming TN medication, please inform your doctor immediately and stop taking it.

What are the commonly used medication for trigeminal neuralgia?

What other drugs than anticonvulsants are useful for TN pain?

Is TN permanent?

What are some of the FAQs about TN?

Is there a cure for Trigeminal neuralgia?

Who is Dr Jaydev Panchwagh?

Youtube videos explaining in detail about Trigeminal neuralgia

Can I hear some patient testimonials? MicroVascular Decompression surgery to cure Trigeminal neuralgia.

How do I contact Dr Jaydev Panchwagh?

Trigeminal Neuralgia Patient Testimonial | Laxminarayan Gogineni

Posted on August 30, 2020 | by Dr. Jaydev Panchwagh | 59 Comments

I suffered from Trigeminal Neuralgia and this is my patient testimonial:

I suffered from Trigeminal Neuralgia for five years before my Microvascular decompression surgery. Symptoms of TN for me was a severe shock like pain along the lower jaw.

Continue reading →

Is Trigeminal neuralgia hereditary?

Posted on August 13, 2020 | by Dr. Jaydev Panchwagh | 162 Comments

For those of you who are wondering whether Trigeminal neuralgia is hereditary, the short answer is ‘ not really’. Having said that, there are cases reported where TN runs in families.

Can Trigeminal neuralgia be Familial?

Familial TN is unusual by all means. It is likely to be less than 2 or 3% of all TN patients. It is possible that patients inherit their familial ‘make-up’ of blood vessel contours or laxity, or lengths…we don’t know. Generally the familial type of Trigeminal neuralgia is on the same side in all affected family members.

Can Trigeminal neuralgia be inherited? Can TN be genetically transmitted?

The chances are so slim, that it’s not worth losing good sleep over it.

Have I seen a case of familial Trigeminal neuralgia?

‘No. I have only read case reports. It is likely that this condition is so rare, that one need not be too worried about it.’ Dr Jaydev Panchwagh answers.

Can children be affected with Trigeminal neuralgia?

Though it is unusual, it is not impossible. Diagnosing TN in children may be a problem, because they may not be able to express their problem clearly.

Parents ought to be more observant and help in establishing patterns.

There are reports of Microvascular Decompression surgery being done even in young children to treat them of the Trigeminal neuralgia pain.

My father and I both have Trigeminal Neuralgia. Is this hereditary? Will my children also have it?

It is possible that there are certain anatomical variations in either the brain and skull, or in the blood vessels that have predisposed both of you to have it. We just have to wait and see if it gets passed on to the next generation.

The youngest patient Dr Jaydev Panchwagh, a renowned Indian neurosurgeon has operated on is a girl of 22 years, who had been having it for five years. The operation was performed at his centre for MVD in Pune, India. With an experience of more than a thousand trigeminal neuralgia surgeries, he is one of the best neurosurgeons for such delicate and specialized operations.

You may watch his Youtube channel for more on MVD surgery for Trigeminal neuralgia treatment.

Is trigeminal neuralgia permanent?

Posted on July 30, 2020 | by Dr. Jaydev Panchwagh | 63 Comments

Is Trigeminal neuralgia permanent? This is one of the first questions patients ask, upon learning their diagnosis. It is natural to want to know how long they have to face these facial pain-attacks.

The pain of a TN attack is itself not permanent, but comes intermittently most of the times. In a few patients this pain, especially in those who have had it for a long time, may last a few hours at a time.

Does the pain of Trigeminal Neuralgia (TN) ever go away?

Unfortunately, no. The pain attacks keep appearing. Initially, the attacks are infrequent, later they become more severe and frequent or even continuous. the timeline varies for every individual who suffers from this.

There are periods, sometimes for months when the pain does not re-appear. It is called pain remission. Some people have short remission periods, and for others it’s longer.

As the condition progresses, the remission periods shorten and the attacks become more frequent. Very rarely, there may be near-permanent remission.

How long does the pain of Trigeminal neuralgia last?

The actual pain attack of TN may last a few seconds to a few minutes. The actual condition is unlikely to ever go away. Most patients need a combination of medications to keep the pain under control. Non-medical therapy helps in managing pain, and living with it. Surgical procedures give longer pain relief. Microvascular decompression surgery is the main option available for a possible permanent relief from the pain of Trigeminal Neuralgia.

Dr Jaydev Panchwagh and his team at the Centre for Trigeminal Neuralgia Treatment by Microvascular Decompression surgery have an experience of more than a thousand MVD procedures, in the last twenty years. The centre is known for the best treatment of Trigeminal Neuralgia.

Dr Jaydev Panchwagh is a renowned neurosurgeon in Pune, India and has many referrals from international patients as well. Plenty of video lectures delivered by Dr Panchwagh on the subject, are available on YouTube.

Trigeminal neuralgia patient testimonial | Ketan Dixit

Posted on July 21, 2020 | by Dr. Jaydev Panchwagh | 39 Comments

Trigeminal neuralgia patient after operation Trigeminal neuralgia patient testimonial

I am Ketan Dixit, and I suffered from Trigeminal neuralgia. This is my testimonial of the treatment I received from Dr Jayadev Panchwagh, an Indian Neurosurgeon famous for trigeminal neuralgia surgery in Pune, India.

I would like to share my Trigeminal neuralgia patient experience with you all. I suffered from this horrible disease for nearly four years before I got operated. I was on Trigeminal neuralgia medications like carbamazepine etc, for many years. Continue reading →

Trigeminal neuralgia patient story. Maria from Mauritius.

Posted on July 16, 2020 | by Dr. Jaydev Panchwagh | 23 Comments

In this section we shall be presenting a series of ‘Trigeminal neuralgia patient story’. The first is Maria from Mauritius.

This is the story of a woman, Maria, who lived in Mauritius. She was 45 years old when she came to us. She had been suffering from pain near her eye from 7 years. Initially she used to massage the area, and then noticed that massaging increased her pain. It used to come in short bursts, for a few seconds, like an electric-shock. She observed her pain for a few months, while her family members dismissed it as something that was not very serious. Over a period of the next few months, the pain spread to the lower part of her eye, near her nose and cheek, and came in more frequent bursts. Unable to tolerate this any longer, she visited her family physician, where she was prescribed many painkillers. They did not help and made her nauseous.

Continue reading →

Doctor heals Mauritian of chronic facial pain (Trigeminal Neuralgia)

Posted on July 6, 2020 | by Dr. Jaydev Panchwagh | 50 Comments

pune doctor sets mauritian free from chronic pain — Trigeminal neuralgia coverage

This is an article on Chronic facial pain (Trigeminal Neuralgia) from Times of India, Pune, published on May 7 2018.

For five years, 60-year-old Sawmy, a Mauritius national, suffered from severe pain in his face. Sawmy is an agriculturist by profession. He is married and has triplets.

The condition, Trigeminal neuralgia (TN) was such that he would go without eating for days together. Medicines would prove useful only for short periods of time. As is common in cases of TN, he was caught between the side effects of the high-dosage medicines and attacks of severe pain.

Any severe pain that remains untreated or partially treated for a prolonged period of time gets complicated, and its intensity worsens. This is termed chronic pain syndrome. In Sawmy’s case, the syndrome had turned his life upside down.

“In his desperate search to find a cure, Sawmy had gone to France — his sister lives there — where he consulted a number of doctors, to no avail. “I was on high doses of medicines. They were mainly three types of pain modulators. I developed drowsiness, forgetfulness and loss of balance due to the prolonged use of the drugs,” he said. All the doctors in France did was prescribe more medicines, which only worsened the side effects for Sawmy. “The repeated attacks of pain caused personality changes — they made me more irritable,” he said.

He eventually found relief in Pune, while browsing on Youtube and the internet. Though he didn’t have any acquaintances in India, Sawmy visited Pune after contacting Dr Jaydev Panchwagh over Whatsapp. “I contacted him for trigeminal neuralgia surgery. This alone speaks about the severity of pain I had, and how desperate I was to get rid of it,” he recalled. He now says that Dr Jaydev Panchwagh is one of the best neurosurgeons for trigeminal neuralgia surgery.

Explaining this unusual case, Dr. Jaydev Panchawagh said, “The drugs prescribed to patients suffering from Trigeminal neuralgia are mainly pain modulators. They are of different varieties or groups. The problem with the drugs is that they don’t target the Trigeminal nerve where the pain originates. So they (the drugs) act on the entire nervous system and cause neurological side effects.”

He added: “In simple words, these medicines numb the nerves. The drugs do not target the basic cause of neuralgia, which is vascular compression on the nerve as seen in majority of the cases, Dr. Panchawagh said.

“A very important aspect is the fact that chronic pain (if persistent for a year or more) can lead to permanent changes in the brain, including shrinkage, especially in the setting of neuropathy. Widespread impact on memory and cognition, sleep, sexual function, and development of hypertension are other important consequences. The psychology of chronic pain can best be understood as ‘learnt helplessness’, that is, the psychology of a person who is trapped in a situation from which there is no escape.”

Microvascular decompression surgery, or MVD surgery, is the most beneficial surgical treatment for permanently treating trigeminal neuralgia, claim doctors. “It is the only procedure which treats the basic cause of the trigeminal neuralgia,” said Dr Jayadev Panchawagh, who carried out the surgery on Sawmy. He has operated on more than 950 other patients since 2005.

Sawmy underwent the surgery under care of Dr Jaydev Panchwagh in Pune. “It has been 22 days now with no attacks of pain. I don’t have to take any medicines post-surgery. It is a huge relief. Surgery has proved to be a boon. I wish I knew about it earlier,” he said, when interviewed after his MVD operation for Trigeminal Neuralgia.

ABOUT THE CONDITION

There are two nerves-one on each side of the face-that carry the sensation from the face and gums to the brain. They are called trigeminal nerves. Sensations from the right side of the face are carried by the right trigeminal nerve. Neuralgia means nerve pain. Compression by a pulsatile blood vessel causes trigeminal neuralgia in a majority of the cases.

How patients describe the pain due to TN

* The worst pain experienced by mankind

* The pain you would not wish even on your enemies

* Death is better than this suffering

* Pain of 1,000 knives piercing the face

* A hot ‘chilli bomb’ exploding on one side of your face

This is a potentially misunderstood medical condition. The behavioural and emotional changes in the patient is difficult to understand for others. It is also a condition that can be diagnosed if one is aware of its existence.

* Trigeminal neuralgia is also known as the ‘suicide disease’ because of the intense pain triggered by talking, eating or even a breeze.

* A study has revealed the 92% of patients were unaware of the diagnosis prior to their doctor telling them..

* Most of them were treated for dental or jaw pain, migraine or even psychiatric illness

* The reason for misdiagnosis is low awareness of the condition.

http://https://timesofindia.indiatimes.com/city/pune/city-doc-sets-mauritian-free-from-chronic-pain/articleshow/64056058.cms