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Doctors' Answers to "Frequently Asked Questions" - Trigeminal Neuralgia
Answer: I'd try the Neurontin. It may not work, but you'll know pretty quickly. Also, if this does not work a pain clinic can block the pain by destroying the nerve causing the trouble. This is not without problems either, but an option considering your side effects. The side effects of Neurontin are usually pretty minimal-especially compared to tegretol
Answer: Usually tegretol will continue to work and you won't develop tolerance if the blood levels are maintained. The facial heat is probably the neuralgia.
Answer: This is the first place to start and usually works, if your blood levels are where they need to be. Have these been checked? Dilantin is sometimes of help or seeing a pain specialist for ablation of the nerve itself.
Answer: Trigeminal Neuralgia refers to the pain secondary to irritation or stimulation of the facial
nerve which goes to the lower half of the face. This is also called Tic Douloureux. This
syndrome is usually seen after age 30. It is extreme pain, usually to the lips and
cheek. There tend to be recurring waves of pain usually lasting less than 1-2 minutes. This
can be triggered by seemingly simple things like a breeze on the cheek. Indeed, light touch
often sets this off, whereas heavy stimulation does not.
There are several ways to treat this pain. Initially, drugs are used. Tegretol(carbazepine)
is usually given first. If this is not successful dilantin(phenytoin) is used. If drugs are not
Successful, radiofrequency ablation (also called percutaneous retrogasserian rhizotomy) is used.
Occasionally, injection of glycerol or something similar is used in place of the radiofrequency
ablation. This surgical approach will give numbness to the face in the affected area. This
pain can occasionally reoccur after surgery in 20 % of patients.