Trigeminal neuralgia attack and its treatment

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 medication-how to take them?

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?

Is trigeminal neuralgia permanent?

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.

 

Calming an attack of trigeminal neuralgia

One of the most important questions I am asked, or rather one of the important phone calls I handle are tips on calming an attack of Trigeminal neuralgia. In other words:

How do I deal with a TN attack?

Well, primarily, it means that you have been diagnosed, and you recognize an attack. But before we learn how to deal with an attack of TN or learning how to calm the trigeminal nerve, we should first check that we have a few things in place.

  • Do you keep a pain diary? 

This is very important to recognize what events led up to the attack, its duration, frequency etc.

  • Have you noticed any trigger factors that bring on an attack?

There are different trigger factors for different people, but the commonest are touch, brushing,                  eating and talking. Maintaining a pain diary helps identifying trigger factors.

  • Have you noticed any actions that may reduce your pain?

Again, being observant and trying different remedies at home in the initial phases when the pain is            not so severe can help.

  • Have you noticed any foods that may bring on an attack?

Writing down in a pain diary will help narrow down pain-triggering foods. One of the problems of              Trigeminal neuralgia medication is that there is an obtundation of memory and recall. Writing                    down helps recall, and can help others also analyze the things that led up to the attack. Also,                        identifying pain-safe foods for you will help ward off an attack.

Simple measures that may help calming down a Trigeminal neuralgia attack

  • Hot water bottles / cold presses
  • Pressure of entire palm on affected side: cupping the face with palm
  • Medication like Tegretol, especially if you have forgotten to take a dose
  • Capsaicin or hot pepper creams
  • Seeking a calm atmosphere
  • Going indoors and avoiding breeze
  • Avoid long journeys
  • Drink from a straw, eat soft foods so you don’t have to chew
  • Light exercise to release natural pain-relieving hormones (for some, exercises like walking can worsen an attack).

My Trigeminal neuralgia attack keeps coming back. What do I do?

Unfortunately, if your TN attacks are non-responsive to medication and other measures, you might have to consider Microvascular decompression surgery. This is one of the treatment options, which when considered early on in the disease, can lead to a potential cure.

 

Dr Jaydev Panchwagh is a renowned neurosurgeon in Pune who is an internationally recognized surgeon for Trigeminal neuralgia treatment in India. he has performed over a thousand MVD procedures with a 98% success rate. He has an international patient service to help those patients coming from outside India.

He has a You Tube channel, Dr Jaydev Panchwagh, if you are interested in watching his lectures on Trigeminal neuralgia. There are also many patient testimonials, which help in allaying fear and anxiety about surgery. Our team has one of the best results in trigeminal neuralgia treatment in India.

You may contact the team which will lead you to avail of all our services.