Facial pain Archives | Trigeminal Neuralgia Treatment

Medicines for face pain

Posted on August 7, 2022 | by Dr. Jaydev Panchwagh | Leave a Comment

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.

What does Trigeminal neuralgia pain feel like?

Posted on August 24, 2021 | by Dr. Jaydev Panchwagh | 1 Comment

What does Trigeminal Neuralgia pain feel like? It is a thought that crosses many a family member’s mind. Unlike a brain tumor or a fracture or a pimple or hernia, pain cannot be seen by others. Only the sufferer who experiences it knows. Others can only wonder and empathize.

Facial pain is the only symptom of this terrible disease of Trigeminal Neuralgia. The pain comes in waves, lasts for a few seconds to a few minutes, and subsides. The pain of Trigeminal neuralgia feels like electric shock to some patients. To others it feels like a knife is being stabbed repeatedly. For a few others the Trigeminal neuralgia pain feels like chili powder being rubbed on the face.

How long does the pain of Trigeminal neuralgia last?

The pain of TN lasts from a few seconds to a few minutes. Very rarely it may last for hours or become continuous. In the initial stages of the disease, the facial pain attacks are less frequent and may be brought on by some trigger factors like talking, chewing and brushing. Later on these trigger factors for Trigeminal neuralgia may be less evident and the pain becomes more persistent. what does Trigeminal neuralgia pain feel like in sleep? It generally allows the sufferer to sleep initially, but makes it impossible to live with. The Trigeminal neuralgia never really goes away, but lingers on and threatens to become a full-blown attack any time, unexpectedly.

Can stress cause Trigeminal Neuralgia?

The cause for Trigeminal neuralgia pain is usually a compression of the Trigeminal nerve by either a blood vessel or a tumor. On its own, stress does not cause Trigeminal neuralgia. However, Facial pain attacks may be brought on by stressful conditions.

How to get rid of trigeminal neuralgia pain?

Initially the treatment of the pain of trigeminal neuralgia is by medication like carbamazepine. Then other semi-invasive treatment may be tried, but are generally only temporary in nature.

What is the permanent treatment of trigeminal neuralgia?

MicroVascular Decompression surgery or MVD surgery is the only potential permanent treatment of trigeminal neuralgia or facial pain.

Where is treatment of trigeminal neuralgia done in India?

Treatment of trigeminal neuralgia is done by neurologists to prescribe medicines. But the cure for trigeminal neuralgia is MVD surgery, and is done by a neurosurgeon.

How to choose a neurosurgeon for MVD surgery?

A neurosurgeon who is a Trigeminal Neuralgia specialist is essential because these are not frequently performed surgeries and need a neurosurgeon who has long experience in MVD surgeries. Dr Jaydev Panchwagh has performed more than 1350 MVD surgeries and has a tremendous experience in treating trigeminal neuralgia. Many patients with failed MVD surgeries come to his MVD Centre of excellence in Pune for revision surgeries.

Trigeminal neuralgia attack and its treatment

Posted on August 17, 2021 | by Dr. Jaydev Panchwagh | 22 Comments

Trigeminal Neuralgia attack and its treatment

Trigeminal Neuralgia attack can be very severe and frequent as the disease progresses, and its treatment at that point in time may be very frustrating. It is when such attacks become frequent that the patient generally tend to take decisions about getting MVD surgery done. In this video, a patient shares her experience during one such attack and how she suffered through it. She also describes how her life changed for the better after she became pain-free after MVD surgery. Dr Jaydev Panchwagh, an eminent neurosurgeon and an internationally acclaimed one performed this Microvascular Decompression (MVD) surgery on her. Having performed more than 1350 MVD surgeries, at his MVD centre in Pune, India, he has a considerable experience in treating Trigeminal Neuralgia. The MVD centre also caters to international patients and has a support group.

Is Trigeminal Neuralgia serious?

The honest answer is yes and no. By itself it does not harm life, (except in cases of C-P angle Tumor) but the disease itself can be so debilitating, and its medical treatment so very challenging, that the patient often considers ending their life because of the pain and the fear of an upcoming TN attack. Click here to read more about the disease.

Trigeminal Neuralgia (Facial Pain) diagnosis

Electric shock-like pain in any or all of the three divisions of the trigeminal nerve brought about by trigger factors usually establishes the diagnosis of trigeminal neuralgia.

Trigeminal neuralgia causes

The pain of trigeminal neuralgia is usually caused by one or more blood vessel compression on the trigeminal nerve or a C-P angle tumor (Cerebellopontine angle tumor). There can of course be other causes. Click here to know more.

Trigeminal Neuralgia attack

The pain in Trigeminal neuralgia manifests as attacks of facial pain generally brought about by trigger factors like talking, brushing teeth, eating etc. The patients experience electric-shock like pain during the trigeminal neuralgia attack. The pain may have different manifestations in different people. click here to know more about Trigeminal neuralgia symptoms.

Trigeminal neuralgia treatment

Though there are many options for treatment of Trigeminal neuralgia including medications, Radiofrequency lesioning (RFLG) etc, Microvascular decompression surgery is the only shot at achieving a possible permanent cure.

Trigeminal Neuralgia Pain Relief

Posted on April 4, 2021 | by Dr. Jaydev Panchwagh | 4 Comments

‘Trigeminal Neuralgia Pain Relief has been the single-most wonderful thing in the last month of my life!! The pain was so bad before the operation, I could not eat, sleep or drink, even talk. And then I underwent Microvascular Decompression surgery or MVD surgery.

Now that my pain is relieved, I feel like laughing, dancing, singing…..I am so ecstatic. I feel that no patient should needlessly suffer the pain.

For me, the Trigeminal Neuralgia Pain relief was so immediate, that I would highly recommend it to all other sufferers. I had visited many doctors, many neurologists, many experts, not only in Mumbai but also other cities and states. But I did not get the confidence that I could be treated well.

Dr Jaydev Panchwagh is an expert in treatment of Trigeminal neuralgia. He is a neurosurgeon based out of Pune. He has an entire team working with him for the last twenty years, that each one on the team has a big role to play in the recovery of the patient.

I have been supported so well during this incredible journey of Trigeminal neuralgia pain relief that I would highly recommend anyone to please visit him at least once.

I too was afraid of surgery before, but after listening to other peoples experiences and reading their testimonials, and talking to them, watching his Youtube videos, I became confident”.