Trigeminal neuralgia medication- Anti-convulsants
Anti-convulsants for trigeminal neuralgia are the mainstay of oral medication treatment. They occupy a significant chunk of the entire armamentarium aimed at treating TN.
Though historically Potassium Bromide was used in late nineteenth century, newer and better drugs have replaced it. Chief among these being Carbamazepine and its congeners like Oxcarbamazepine.
Which are the newer anti-convulsants used for TN?
Newer anti-convulsants are also being tried for treatment of the pain of Trigeminal Neuralgia, chief of these being Gabapentin, Topiramate, Lamotrigine and Levatiracetam.
How do anticonvulsants work in Trigeminal neuralgia treatment?
We need to first understand the cause of Trigeminal neuralgia. The “cross-talking” Trigeminal nerve fibres interpret normal sensations like touch wrongly. This makes them fire and send wrong signals to the brain.
Some conclusions can be drawn from this. Any medication that calms the nervous system or makes it less responsive should work in the treatment of TN pain. Anti-convulsants just mask the fire raging within.
Though this is a very effective way to treat the TN pain initially, it is not very specific. Which means that they do not act on the Trigeminal nerve alone. They numb or calm the entire nervous system. This results in slowing down of all responses- co-ordination, gait, memory, reaction-times etc.
What are the side-effects of anti-convulsant medication?
- Drowsiness,
- dizziness,
- lethargy,
- fuzzy mind, reduced memory
- worsening co-ordination,
- gait disturbances, ataxia
- sexual dysfunction,
- lack of enthusiasm etc
are the commonest side-effects of anti-convulsants, apart from allergic reactions.
Apart from the anti-convulsant group of drugs, there are certain other medications that could be tried.
Can we combine non-medical treatment with anti-convulsants ?
Certainly non-medical treatment can be tried. But do this only after consulting your primary neurologist or neurosurgeon.
Can Homeopathic medication work for Trigeminal neuralgia?
Yes, they do. you need evaluation by a registered and experienced doctor to find good relief.
How useful are anti-convulsants for treatment of Trigeminal neuralgia?
About a half of the TN patients experience moderate to good relief after the initial dose. Slowly, this dose become insufficient, and needs to be increased. This process keeps repeating till the doses are high, and side-effects start manifesting.
Can anti-convulsants alone treat Trigeminal neuralgia?
Yes, but quite often they need supplementation with other drugs as well.
Can medication permanently cure Trigeminal Neuralgia?
In a small sub-set of patients, yes. Typically most patients start getting troubled by their side-effects and seek an alternative treatment.
Do anti-convulsants treat the root cause of Trigeminal neuralgia pain?
No. The cause is neuro-vascular conflict at the Root Entry Zone(REZ). Anti-convulsants only numb the nervous system.
Which is the drug of choice for Trigeminal neuralgia?
Carbamazepine or its congeners
What is the permanent cure for trigeminal neuralgia?
Microvascular Decompression surgery is the only shot at a permanent cure from Trigeminal neuralgia. No procedure gives 100% guarantee of results, but MVD surgery is generally successful in 98% of TN patients. The high success rate is because of the treatment of the cause of the pain: blood vessel compression.
Dr Jaydev Panchwagh has performed more than a thousand MVD surgeries in twenty years with a very high success rate.