trigeminal neuralgia followed by general parathesia

    
      Re: trigeminal neuralgia followed by general parathesia
    


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Posted by CCF NEUROSURGERY MD on October 07, 1997 at 11:37:19:

In Reply to: trigeminal neuralgia followed by general parathesia posted by Tracy L. Jones on September 30, 1997 at 21:57:07:

:      One year ago, I was diagnosed with trigeminal neuralgia.  After
  treatment with prednesone, the symptoms lessened from 8 to 2 on a scale
  of 1 to 10.  In the months following, I began to have numbness and tingling
  in other parts of my body.  These feelings move from one area to another.
  Sometimes they are present, and sometimes not.  I have a general feeling of
  weakness, and at times the tingling is very painful.  Currently, I am being
  treated with prednesone again.  My doctor ruled out MS a year ago by MRI
  results.  Another doctor has told me that MS cannot be ruled out by MRI.
  Who is correct?  Do these symptoms sound like MS?  I was exposed to
  shingles a week before the TN began.  Is it possible that the herpes virus
  could be in my nervous system causing these problems?  I have seen a
  neurologist; he suggested that I return when I was properly insured.  I
  would appreciate any relevant information you can provide.  As I am a
  medical professional, please do not oversimplify any responses.  I would
  appreciate any suggested research topics for me to learn more about this
  condition.  Thank you for your time.  
_______________________________________
_______________________________________
Dear Tracy,
Trigeminal neuralgia is a condition characterized by brief paroxysms of
intense pain in the cheek or jaw area on one side of the face.  These painful
episodes may be triggered by a simple touch, heat, cold, chewing food, etc...
The pain has been described as being very intense, like lightning.  Once
diagnosed, usually by history, medical therapy is the first line of treatment.
Tegretol, an anti-seizure medication, is often effective.  Should the pain
become refractory to Tegretol, other therapies such as injections, balloon
ablations and formal surgery may be considered, depending on the patient.
It is unclear what is causing your present generalized weakness and sporadic
numbness.  Multiple Sclerosis (MS) may be considered in a younger patient.  
MS is an inflammatory condition of the nervous system of unknown cause that
creates focal areas of demyelination and subsequent neurological deficits.
The diagnosis of MS rests primarily in a history of different neurological
deficits occurring over time.  It is supported by characteristic findings
on MRI and information gained by a lumbar puncture.
Your neurologist would be the best resource for answers at this point.  You
need a clear understanding of what he or she thinks of your history in light
of the physical exam and MRI results.  The simplest answer may be that you
are not tolerating the prednisone, and a switch to Tegretol may be a good
option.  Talk to your neurologist.
Good luck.

[smurf102]

A related discussion, Pain was started.