.I was diagnosed with trigeminal neuralgia 8/10.had a MVD performed 1/11. after surgery my neuro told me that a vein had fully bonded to the nerve as well as a thckening of my archanoid membrane which had wrapped around the nerve as well. He killed the nerve and removed what membrane he could. ever since surgery most of the sharp electrical pains were gone and i woud occasiony geta little zing or ping in my face along the trigeminal pathway. about a month ago i had a full return of symptoms thought not electrical in feeling.and now they are bilateral symptoms. i went back to my suregon, pain doc, and neuro and none could give me an answer. my surgeon order a mri with contrast as wel as a cervical mri. it showed enhanncement around the surgical site which my neuro seemed concerned about giving the length of time since surgery. but he didnt elaborate on it at all. also the mri showed a disc compression and bulge in c5-c6. but suregon didnt seem concerned though i do have quite a bit of back pain.also in all of my mri's since the first diagnoses in 8/11 there have been white matter lesions though this last one states they are not in the typical form of multiple sclerosis. i am quite concerned about all of this for various reasons and whats worse is i dont understand why any of this is happening. i try to get explanations from my docs but they seem hestiant. pls help make sense of this for me if you can. should i be concerned about the enhancement of the area,or about the bulging disc? what questions should i ask my docs? any help is greatly appreciated.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
With regards to the disc bulge: There is a material that cushions the space occurring between the vertebra (bones of the spine). This material may sort of be squished out from in between the two bones; this is called a herniated disc. The disc may push on surrounding structures, namely the spinal cord and/or the nerves exiting from the spinal cord. Most often, it is the nerves that are pressed on, and not the spinal cord itself.
In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people every require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.
In a minority of patients, surgery needs to be done urgently. This often is the case when the herniated disc is pressing on the spinal cord itself. Surgery is emergent so that permanent spinal cord injury does not occur. Another indication for urgent surgery is if there evidence that a nerve is being compressed on to the point that its function is impaired. Symptoms suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.
I am not sure what to make of the enhancement on your brain MRI since I cannot see the images. I would suggest you discuss this with the surgeon who performed the operation. This is also the person I would suggest you visit to discuss the bilateral pain.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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