Trigeminal Neuralgia and Pregnancy

trigeminal-neuralgia-pregnancyFor people who suffer from trigeminal neuralgia and are considering or are pregnant, then the doctor will suggest they come of the drugs.

Early in the stages of the pregnancy the doctors will recommend stopping the use of pain medications to help with trigeminal neuralgia. The doctor will determine when or what situation the pain medications are needed.

The reason behind this move is that the drugs can affect the unborn child. There are some medications that are considered to be “safe” to be taken while pregnant,  but this is why it is important to correspond with the doctor.

The side effects of the drugs may include birth defects and other problems that could arise throughout the pregnancy.

For some people who are pregnant and have trigeminal neuralgia, the pain might be bearable, for others it could be a nightmare, especially if the medication is not available to treat the condition.

In being off the pain medication, some people have to find other methods to cope with the pain problems. The biggest advice to keep the pain away is to not chew, crunch or do anything that could cause the pain to start.

Trigeminal Neuralgia and Acupuncture

acupuncture-trigeminal-neuralgiaTrigeminal neuralgia is a condition that affects the trigeminal nerve. The condition is also known as “tic douloreaux” due to the fact that facial muscle spasms often accompany the pain. This debilitating condition is one that often produces intense, periodic facial pain along one or more of the three branches of the trigeminal nerve. The pain the person who suffers from this condition is very painful and it can last anywhere from seconds to minutes. The pain from trigeminal neuralgia can often be activated by simple activities such as brushing of teeth, eating putting on makeup or washing the face. Stress, heat, wind, or cold may also intensify the condition. It is often common in women who are over 40. Trigeminal neuralgia may become debilitating due to the chronic pain and it can last for years.

The treatment for trigeminal neuralgia is often surgery or drug therapy treatment. To control the pain doctors may administer drugs; however these usually have significant side effects and risks. Surgical intervention is usually the last option available to provide relief.

Acupuncture and Trigmenial Neuralgia

If you suffer from neuralgia or facial pain, then acupuncture treatment should be considered.  The trigeminal nerve serves three areas of the face and it roughly corresponds to the forehead and eyebrow, the eye and cheek and upper jaw, and the lower jaw. Trigeminal neuralgia can be associated with structural problems inside the skull and doctors will often treat it with drugs or surgery. Acupuncture is an option for some people as there are few side effects compared to surgery and drugs.

Developed in China over 2500 years ago, acupuncture has been used for the treatment of painful medical conditions that affect the head and these would include trigeminal neuralgia. The theory of acupuncture is based on energy flowing through the body on specific pathways called meridians. When the pathways become blocked, pain often develops. Acupuncture often require others very fine needles been inserted into these points on the pathway to enable the smooth flow of energy. This will also result in pain relief. There are many acupuncture points in the face that will directly link to the three branches of the trigeminal nerve. In using acupuncture to treat trigeminal neuralgia, very fine needles are placed into the corresponding facial points as a way to unblock the energy. There are times that the needles will be stimulated with electricity as a way to strengthen the overall treatment.

Over time the pain associated with the condition will become more complex and difficult to treat. As a result of this acupuncture should be done as soon as the symptoms appear. Acupuncture is shown to be more effective when applied immediately after the appearance of the syndrome.

The Success of Trigeminal Neuralgia and Acupuncture

There is no research or studies done to show if acupuncture is able to successfully treat trigeminal neuralgia. Many people have claimed success in using acupuncture to treat their pain and some have said that they are pain free or the pain is not as harsh as it used to be before. On the other hand, there have been people who suffer from trigeminal neuralgia and have acupuncture done and experienced no change in their condition. The results may vary and acupuncture should not be seen as a definitive method for treatment of this painful condition. Alternative medicine does work, however it is good to get an opinion from a doctor.

Gamma Knife Surgery for Trigeminal Neuralgia

What is Gamma Knife Surgery?

Gamma Knife surgery is one of the more popular treatments for people who suffer from brain tumors. Over the years it has proved itself as an effective treatment for people who suffer from trigeminal neuralgia. It is a non-invasive procedure that can be applied to patients where brain surgery is not an option.

Gamma Knife is the same as neurosurgery, except that it is non-invasive. As a result of this, there is no need for surgical incisions to be made to expose the brain. This reduces one of the risks that can occur from surgical complications. The Gamma Knife is not a knife but it is complex machine that uses cobalt-60 as the energy and is able to focus a precise intersection of 201 beams of these gamma rays to perform radiosurgery. During the treatment the 201 beams of gamma radiation are focused at eliminating the lesion. Once this has been applied, the lesion should reduce in size and eventually disappear. The brain tissue is not over exposed to the gamma beams and only the treated tissue is affected.

Gamma Knife patients are able to enjoy the benefits from this non-invasive form of brain surgery. They have very few risks and a long hospital stay is not required.

The Use of Gamma Knife and Trigeminal Neuralgia

The Gamma Knife has been used for years in the treatment Trigeminal Neuralgia. This type of radiosurgery has become the treatment of choice for people who do not respond to the typical medical therapy. The advancement in imaging as well as the experienced gained from its use has aided in the success of this practice.

The first use of the gamma knife on Trigeminal Neuralgia was in 1951, when the inventor, Lars Leksell used this radiosurgery technique to target the trigeminal ganglion. He used a conventional stereotactic frame and produced an orthovoltage x-ray tube that was used to target the region. The results from this period over the next 40 years were less than stellar; this was due to poor fixation of the target as well as poor imaging. 1996 brought about a study from the University of Pittsburgh, where they decided to revist the use of radiosurgical treatment of trigeminal neuralgia. Aided by the use of High resolution MRI, they were able to target more accurately. They also targeted the the proximal trigeminal nerve near the pons rather than the ganglion, as was done in previous attempts. The study resulted in 94% of patients who participated in the study having a significant reduction in the pain they felt. There were some patients, who experienced complications, but this was mainly limited to facial numbness and this often occurred at a frequency of less than 10%. Gamma Knife surgery for trigeminal neuralgia has become a safe alternative to the more traditional forms of surgery and also one of the major treatments.

How is Gamma Knife Surgery Performed?

For the surgery to be done properly you need to have a multidisciplinary group of assembled. Generally this will include radiation oncologist, neuroradiologist, neurosurgeon and medical physicist. These are needed to achieve an effective and safe treatment.

The use of Gamma Knife surgery to treat Trigeminal Neuralgia is often done in four steps.

In the first step of the treatment a Leksell stereotactic head-frame is placed on the patient. This is done as there needs to be high quality and accurate imaging. To get great results, magnetic resonance imaging often used in the process. From here the trigeminal nerve is identified and the gamma knife and all can be used to eradicate the target. The trigeminal nerve is often targeted at the location of an imaged vascular compression, or at the site of exit of the trigeminal nerve from the pons if no compressing vessel is identified. The success of the treatment at this exit zone is often due to the fact that the proximal nerve is covered by oligodendrocyte myelin, which is usually more radiosensitive than the distal swan-cell myelin. That could be one explanation or it could also be due to the fact that the concomitant irradiation of the dorsal root entry zone in the brainstem.

Great care is taken in this procedure to ensure that the brainstem is not affected by radiation. Because the Gamma knife is very accurate this can be easily accomplished. This process is the often done under local anesthesia.

During the procedure, great care is taken to ensure that the brainstem is protected from radiation exposure. This can be accomplished easily from the precision of the Gamma Knife. The entire procedure is performed under local anesthesia and mild sedation.

Results of Gamma Knife on Trigmenial Neuralgia

Patients who usually have Gamma Knife surgery done on Trigmenial Neuralgia often report an immediate decrease in pain. Attacks still occur, but the pain associated with it is milder than what they were used to. As the weeks progress, many patients reported that they experienced no new attacks. This is probably secondary to delayed demyelination injury to the nerve. There are also some views that the gamma knife irradiation has a differing effect on the myelinated and unmyelinated fibers. This in turn leads for the pain to be controlled, without dysesthesia.

The results from different studies have shown great success in treating the condition.  Ninety percent of patients with trigeminal neuralgia experienced a significant reduction in the pain they felt after around four weeks. The study went on to show that one-third of the patients experienced some amount of numbness in the face, but 80% showed a significant improvement in their quality of life since the numbness was much more tolerable than the facial pain.

In over 30 years, more than 100,000 people have received gamma knife treatment. The use of the gamma knife has clear advantages to open surgery in many cases, and its use will continue to grow.

Gamma Knife Effective At Treating Trigeminal Neuralgia

trigeminal-neuralgia3Research has shown that Gamma Knife Stereotactic Radiosurgery (GKRS) is an effective treatment for the medical condition trigeminal neuralgia. This is a common condition that is characterized by excruciating facial pain.

Gamma Knife has proven itself to be as safe and effective treatment for people who suffer from trigeminal neuralgia.  It is very popular as patients won’t have to worry about the potential facial paralysis and the long-term recovery experienced with conventional surgery.

Research studies conducted have only way to the outcome of patients who have had gamma knife radio surgery for their trigeminal neuralgia. A group of 400 patients who suffered from the condition were given 201 narrow “pencil beams” of radioactive cobalt-60 at the trigeminal nerve focusing precisely on the target and minimizing radiation effects to surrounding healthy tissues.

In the study 90% of the patients with trigeminal neuralgia had significant pain relief after around one month. Approximately one-third of these patients did experience some degree of facial numbness, but 80 percent reported a significant improvement in their quality of life since the numbness was much more tolerable than the facial pain.

Trigeminal neuralgia, also known as tic douloureaux, is a condition that is characterized by electric shock-like pain in one or more of the three trigeminal nerve distributions in the face. Common triggers of pain associated shall include brushing the teeth, eating, talking, wind and exposure to cold air.

Computer program lets people with Trigeminal neuralgia diagnose themselves

trigeminal-neuralgia2Trigeminal neuralgia, or TN, is a medical condition that affects areas of the face where the trigeminal nerve’s branches are distributed. These areas would include the eyes, lips, scalp, nose, forehead, upper and lower jaws. The condition is often caused by an artery that causes compression to the nerve. This will result in the person feeling mind-numbing, stabbing electric shock-like pain.

This condition said to book the most severe types of pain known to humanity. The most common forms of trigeminal neuralgia affects 1 in 15,000 to 20,000, but 1 in 5,000 are thought to suffer from some type of facial pain.

This condition is often known as the suicide disease as the people are often in total agony. For some people if they touch their eyebrow it feels as if they stuck their finger in an electrical outlet. If they go outside and the wind touches their face, it will feel like the most intense toothache ever.

Despite the pain, new research has developed a new method for classifying and diagnosing TN. This method will allow the patient to do much of the diagnosis themselves. A research team has developed the world’s first online, artificial neural network to be used as a diagnostic tool for facial pain syndromes. It is an artificial intelligence-based computer program built around a classification scheme that categorizes forms of the disorder, and it can be trained to recognize patterns in facial pain data and continually improve its accuracy in predicting the correct diagnosis.

If a patient is able to have an accurate diagnosis, that means they will be able to quickly seek appropriate treatment. Sometimes a patient may state that there have been a pain and go to the dentist, from there the dentist might give them a root canal. This could continue until it is decided that the source of the pain might be something else.

The main researcher has used an 18-point questionnaire he developed that will allow him to clinically diagnose facial pain. Since facial pain types are based almost solely on a patient’s medical history, the questionnaire is comprised of yes-or-no questions that tend to make a difference in establishing the target diagnosis, such as whether the patient has multiple sclerosis, has suffered a facial injury or has had surgery for facial pain, and whether the pain is on just one side of the face or manifests during certain daily activities, like shaving or eating.

The responses they get from the questionnaire is then used to place the patient into one of seven trigeminal neuralgia categories. Type 1: or spontaneous, but severe and brief pain. Type 2: or spontaneous, more constant pain; trigeminal neuropathic pain from facial trauma, oral surgery, stroke or other causes; trigeminal deafferentation pain from procedures that intentionally injure the trigeminal nerve system to relieve other pain; symptomatic trigeminal neuralgia from multiple sclerosis; postherpetic neuralgia from trigeminal shingles; and atypical facial pain, which is more psychological rather than physiological in origin.

Burchiel doesn’t think patients should have to wait until a clinic visit to get a diagnosis, so he developed the artificial neural network, which patients can easily, and confidentially, access on the OHSU Department of Neurological Surgery’s Web site.

The computer system when used was able to accurately diagnose most of the patients who suffered from the condition. It also correctly diagnosed trigeminal neuralgia Type 1 with 84 percent sensitivity and 83 percent specificity among another 43 new patients who used the network before their clinic diagnosis. Sensitivity is a measure of a diagnostic tool’s ability to make a correct diagnosis, and specificity describes its ability to avoid a misdiagnosis.

One treatment for trigeminal neuralgia is surgery that is calledmicrovascular decompression. The procedure involves entering the brain through a small incision behind the ear. Once in there, the doctor will try to find and expose the trigeminal nerve with a powerful surgical microscope. The doctor will then position a piece of Teflon between the nerve and the artery that’s touching it and causing the pain.

Generally the procedure will offer longer-term relief from facial pain.

Oxycarbazepine As Effective As Carbamazepine in Treating Trigeminal Neuralgia

oxycarbazepineOxycarbazepine  (OXYCARBAZEPINE  ), a keto-analog of carbamazepine (CARBAMAZEPINE), is as almost as effective as carbamazepine for the treatment of the condition trigeminal neuralgia. A double study conducted the shoulder it is better tolerated.

A study was conducted at the University of Michigan the in Ann Arbor, Michigan to look at the findings of Oxycarbazepine  arbazine on a study group. The researchers had 46 patients were over the age of 40 years old in the clinical trial. These people had new onset, previously untreated idiopathic trigeminal neuralgia. 24 patients were randomized to receive Oxycarbazepine  and 22 to receive Carbamazepine.

All patients over a two- to four-week period were given an initial dose 300 mg Oxycarbazepine  twice daily or 200 mg carbamazepine twice daily. This was then followed by a four-week maintenance period.

The most frequently doses used were Oxycarbazepine 750 mg per day and Carbamazepine 500 mg per day. Researchers noted that there were no significant differences between the groups for any efficacy variable.

In the two groups, 100% of patients responded to treatment and 50% became pain-free. 70% of those who were taking Oxycarbazepine had a significant reduction in pain compared to 59% of those who took Carbamazepine.

One patient in the Oxycarbazepine group discontinued treatment due to a rash.

The results that researchers gained from this study suggested that Oxycarbazepine is an effective treatment alternative to Carbamazepine for patients who suffer from new onset trigeminal neuralgia.