Re: Trigeminal neuralgia

Posted By CCF Neurology  on February 02, 1998 at 17:12:48:

In Reply to: Trigeminal neuralgia posted by Angelina malonni on February 02, 1998 at 13:49:48:








My best friend has been diagnosed with T.N. recently. She is 33 years old and has always been in good health condition. She is presently taking 400 mg. of tegretol per day and she is still experiencing sever pain. How do we know how much tegretol to take and how long should we wait before we see any changements? She is also experimenting a constant headache and pain in her forehead, neck and behind her right ear. Is this part of the T.N. symtoms (symptoms) or can she take anything else to relieve the pain ? She has tried fiorenal, cortison, codein, extra strenghth tylenol Nothing  works....What do you suggest.  Thank you very much. Hoping fotr a reply soon. Thank you for doing all this for  us.
Dear Angela,
Trigemianal Neuralgia is a diagnosis made on a clinical basis. Symptoms frequently consists of breif episodes of  "electric" or "hot/burning" pains that last a few seconds to minutes.  Epsides can occur multiple times throught the day and our frequently triggered by touching or stimulating the face.  Symptoms are usually felt on one side of the face. They can occur on the skin on the forhead, nose, cheek, mouth, and ear. Pain is not found on the neck. Tegretol is one of the most popular medications used to treat T.N.
Frequently a response to tegretol is seen within a few hours of taking the medication. If no response is seen, a higher dose may be needed. The 400 mg that you are currently on is a moderate dose.  Some additional medicaions that are also used for T.N. include phenytion, valproic acid, clonazepam, baclofen. These medications can be used alone or in combination .  Surgery is also an option if medical therapy fails.  In addition, if your symptoms are "atypical" for TN and there is not a significant response to therapy other reasons for the symptoms should be sought. It is best to contact your primary physician to explore the other medications options as well as for further work-up if needed in the future.