trigeminal neu & stroke survivor & meds

    
      Re: trigeminal neu & stroke survivor & meds
    


[ Follow Ups ] [ Post Followup ] [ The Neurology Forum ] [ FAQ ]



Posted by CCF Neuro MD on August 30, 1997 at 07:58:30:

In Reply to: trigeminal neu & stroke survivor & meds posted by sally martin on August 29, 1997 at 17:59:05:

: my 85 yr old mother recently survived a stroke on her left side...excellent
  rehab response and determination to return to full functioning...
  has had periodic flares of trigeminal neu in the past few years, treated somewhat
  successfully with tegretol, altho when this first prescribed 2-3 years ago,
  it made her very ill at start of medication.  but with tolerance of med, came
  cessation of tn symptoms...however, latest flare-up has been very severe...
  tegretol useless...pain still there...additional  prescription made for
  neurontin 300 mg...only been taking two days...very dizzy (side-effect of
  tegretol, worsened by neurontin)...am very concerned about combination of meds.
  in addition to neurontin and tegretol, takes 250mg ticlid 2x day and norvasc
  (sp?) 5mg 1x day.  am at wits end as to how to advise her...is there no solution
  other than living with drowsiness, pain, and dizziness?  SHE LIVES ALONE!!  
  help...
============================================================================================
Hello Sally,
  It seems that your mother has had a rather difficult time of recovery from the stroke.  The symptoms that she experiences are not uncommon with those medications.  As you have noted, sometimes the side-effects become more tolerable after being on certain medication for a while.  Unfortunately, it is difficult to predict which drug will behave this way.  Usually after several months of trial, for sure you will know if the patient will be able to tolerate or not for long term therapy.  Speaking of her specific conditions, most patients with trigeminal neuralgia respond to tegretol  with or without neurontin.  Other meds that have been proven to be beneficial include phenytoin (Dilantin), valproic acid (Depakote), and clonazepam.  Surgery with radio-frequency has been helpful in some patients.  Ticlid is a rather new medication treating stroke.  The symptoms that she is experiencing are not common with ticlid.  With her overall condition, you need to make sure that her blood pressure is well controlled, because drowsiness and dizziness can well be from fluctuation of blood pressure.  She may also need a visiting nurse to monitor her BP at home.  I would be really concerned as you are about whether she should be home alone.  I think she needs a post stroke neurological/rehab evaluation to reestablish baseline of her level of function.  This can be done with here at Cleveland Clinic if traveling to Cleveland is not a trouble for her.  Please call toll free [phone] ext. 45559 for an appointment.  Good luck.
  This information is provided for general medical educational purpose only.  Please consult your physician for the diagnostic and treatment options of your specific condition.