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Arrested Hydrocephalus and Trigeminal Neuralgia
I have had TN (Trigeminal Neuralgia) now for about 17 years. Sharp stabbing pain at times right side of face, usually centered around upper right teeth/top of lip/bottom of nose area. Have had two Gamma Knife procedures done 10/05 and then 10/08 after pain had returned early '08. Pain has returned this spring and continues. Recent MRI shows no changes from before. I also was told long ago that I had "Arrested Hydrocephalus" thus causing my neurosurgeon concern about doing MVD as he was worried the Hydrocephalus more move from its arrested state. No one is sure what the heck to do now as they don't really want to do another GK--never has done 3 on a patient! He suggests now consulting with another neurosurgeon to do an EVT which has been know to treat hydrocephalus. Perhaps this would relievepresure on the nerve from the hydrocephalus they think? This is a newer procedure now that might be of help? My neurologist doesn't think much of this idea and to just take more meds. I basically take the maximum of 2400mg of Trileptal a day which gets me through but can't bite down on anything on the right side of my mouth, and it is not a dental matter as best I can tell. Any thoughts on EVT and TN?
Best Answer
MEDICAL PROFESSIONAL
Hi, Thank you for your question. Trigeminal neuralgia may have a triggering factor like recent history of tooth extraction, touch, cold breeze or hot sensation etc. which you need to evaluate and avoid. Drug of choice for trigeminal neuralgia is carbamazepine but as the dose may vary according to severity therefore I would advice an oral medicine specialist consultation or at least a physician to confirm this diagnosis and get you treated accordingly. Besides the treatment of hydrocephalus is surgical shunt placement. An alternative treatment for obstructive hydrocephalus is endoscopic third ventriculostomy but it may not be applicable to all patients depending upon internal anatomy of brain. Hope this information proved helpful.
Hi, I just wanted to state that I also had arrested hydrocephalus and this was thought to be causing the TN pains that I was suffering with for a year or so.
From the initial MRI that I had done though, it wasn't thought to be a cause, as I must have had it from birth without any complications for the first 29 years of my life! (so I was told).
Anyway.. Although some of the medications I was put on for the TN did relieve the attacks that I used to get, they stopped working over time and that's when one of the neurosurgeons suggested ETV as a procedure to see if that would help. It had also worked for one other patient of his and I would have had to have it done anyway if I was to have MVD or any other procedure, as like you said, they didn't want to move the hydrocephalus from its arrested state.
Took several months for the pain to completely go but I noticed a difference almost immediately after the operation. I could eat and drink again, put it that way. The pain was a different kind of pain in my face and one that I could just about put up with, enough to eat and drink. And now I'm completely pain free. I'd be interested to hear how you got on and what you decided to do.
From the initial MRI that I had done though, it wasn't thought to be a cause, as I must have had it from birth without any complications for the first 29 years of my life! (so I was told).
Anyway.. Although some of the medications I was put on for the TN did relieve the attacks that I used to get, they stopped working over time and that's when one of the neurosurgeons suggested ETV as a procedure to see if that would help. It had also worked for one other patient of his and I would have had to have it done anyway if I was to have MVD or any other procedure, as like you said, they didn't want to move the hydrocephalus from its arrested state.
Took several months for the pain to completely go but I noticed a difference almost immediately after the operation. I could eat and drink again, put it that way. The pain was a different kind of pain in my face and one that I could just about put up with, enough to eat and drink. And now I'm completely pain free. I'd be interested to hear how you got on and what you decided to do.
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