Trigeminal Neuralgia

[hawkwind]

I have a recent dx of Trigeminal Neuralgia from Primary Care and have been referred to Neurology for further evaluation. The pain distribution is unilateral and follows the sensory distribution of cranial nerve V at the maxillary area. History of previous trauma (neuroplasia) dates to 1997, though  asymptomatic to current presentation. There is no prior history of TMJ, aneurysms, tumors or other common precipitants. I am 61 years old, consistent with typical onset. The severe pain is transient and stabbing with no obvious triggers. Attacks are either individual or, more commonly, in clusters, punctuated by periods of relief.

The pain centers on the upper left quadrant in the region of tooth #12, an area of prior aggressive dentistry, with root canals and a cantilever bridge. #12 has a short fill. The other teeth test vital with endodontic evaluation, suggesting a medical, not dental, problem.

Pharmacologic therapy is disinclined given the adverse profiles of anticonvulsants and benzodiazepines. Somnolence and ataxia would be undesired. Microvascular decompression of the 3rd nerve via craniotomy seems to carry a low risk-to-benefit ratio, aside from the standard surgical concerns.

My questions are twofold:

(1) As a Kaiser patient, I am always concerned about competency. How would I best prepare for a Neurology appointment. What is a reasonable expectation from an exam (procedures, labs, tests, etc.) to differentiate this problem correctly as being medical, not dental, TN vs. sinusitis or other etiology?

(2) Are there any natural medicine strategies (minerals, herbs, vitamins, chiropractic, acupuncture) that have demonstrated efficacy beyond anecdotal reports?

Thank you in advance for your consideration.

[hawkwind]

I'm so sorry to hear of your mishap. The university has an excellent facility. I am quite familiar with it. You certainly require no reminder concerning surgical risk. As always, due diligence applies to any decision of this magnitude. It surely must have been a last resort. The vertebral artery can also be compromised with chiropractic manipulation. I'm curious to know the pattern of your experience. Did the symptoms steadily increase in frequency and intensity or were there periods of relief? What were your experiences with Tegretol and the benzodiazepines? How old were you when these symptoms presented? Had dentistry played any role in the equation?

[jcip]

I was diag. in 2004 with Trig. Neu. as well. I tried all of the medications out there for this. I was told that I had two options. Either the radiation therapy or undergo the "Microvascular Decompression". I opt for the surgery. BIG MISTAKE. I had the procedure @ UMD hospital and did alot of research before I had it done. To me, it looked like a pretty easy procedure, I know all surgery has its risks. But I was never told to me that they might cut my vertebral artery. And that is what happened. I almost died. Most people would of had a stroke from this, but I did not. I have though had alot of complications with this injury that the surgeon did. And the pisser is that I can't get any doctor in my area to see me and even tell me what to look for, etc. Please be careful and do your research. Ask alot of questions to your doctor before doing anything. Remember, it is in the brain area.