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Posted by CCF MD on November 13, 1997 at 10:16:19:
In Reply to: 5th Cranial Nerve Damage posted by Lynn Margien on October 28, 1997 at 00:41:14:
: My ear specialist and neurologist have diagnosed me with severe 5th cranial nerve damage. I suffer from "rods of electric" like pain that shoots down from the side of my head to just below my right ear (over the mastoid process). The right side of my face becomes painful then gradually goes numb. I have had seven right ear surgeries which included the removal of a rather large cholesteatoma several years ago.
The doctors perscribed Neurontin (300 mg) three times a day. The medication is a blessing because it seems to make the pain duller, though at times it is difficult to function because of the increase in occurance and severity when the weather is cold. My doctor wants to increase the dosage of the medication, but I have a difficult time functioning with the amount currently perscribed.
My questions are: 1. What is the prognosis for this type of problem?
2. Is there any way to combat the sleepiness which the medication causes?
3. Is it advisable to locate to a warmer climate....are there really any medical benefits?
4. Is there any other treatment available for this problem?
Any information that you can give to me regarding 5th cranial nerve damage would be greatly appreciated. Thank You!
A number of your symptoms sound like trigeminal neuralgia. We have written extensively on that in our forum
and you can certainly browse the comments on those. Your situation, however, is complicated by the multiple ear surgeries
and it sounds like you are having neuralgic type pain. The treatment with neurontin has recently gained favor
with this type of pain secondary to it's low side affect profile. One of the most common side affects is drosiness. This
is sometimes transitory and can be reduced by increasing the medication slowly. Another option is to switch to tegretal which
is the medication with the greatest history of use in this disorder.
I'm not sure that moving to a warm climate would give you enough relief.
If the problem truely is TN then you do have some surgical or treatment option other than medication and those have been previously discussed in other answers.
The surgical procedure of choice is microvascular decompression. Gamma knife is also becoming and option.
If you would like a consultation to further discuss these then you can call
216 444 5670 and schedule an appointment with Dr. Barnett in the department of neurosurgery or call
216 444 5559 to see one of the neurologists first. Good luck.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment
options of your specific medical condition. Good luck
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