atypical trigeminal neuralgia

[debyep]

Hello,
  I am a 39 year old female who developed right side atypical trigeminal neuralgia about a year.  I have had extensive dental on and major ear surgery on the right side.  Recently I developed a pain that was excruiating and out of control lasting for a week until a neurologist put me in the hospital and gave me IV Thorazine and Decadron.  He then referred me to a neurosurgeon who basically said I wasn't a candidate and gave me a steroid pack to take.  I don't know if it's the Lyrica 150mg a day or the Tegretol 700mg a day or the steroid that is making me better?  Now that I'm weaning down off the steroids I feel the sensation in my face coming back.  Could it been just inflammation?  I work at a very high functioning job that I need to have all my brain intact.  I now after being on meds for 6 weeks am noticing the side effects.  I feeling very hopeless that this will be a constant battle.  Is the gamma knife procedure an option for atypical neuralgia?

[painterchic]

I know this post is old, but you never know who reads again later. Like me! I would agree that your problems may stem from that ear surgery. That nerve is right beside the TN and is one at risk during surgery, so that makes sense in a way.   I have atypical TN and was also told that I am not a candidate for the surgery. After finally being seen by a top neurosurgeon at a top teaching hospital, I was very hopeful to put an end to this all with  MVD or second choice gamma knife, but because mine is probably caused by shingles and did not appear suddenly (ideopathic TN) then my success rate drops and risk rate increases. I just got off Tegretol which made me sleepy and dopey and not funtional mentally, as well as gave me a terrible case of the hives sending me to the E.R. multiple times in one week. Lyrica took the edge off but never gone. I have heard wonders of lidocaine nose spray that you can get from a compound pharmacy and may try that. I would love to know other options besides major drugs that sometimes seem worse than the  TN.

[TN_Shingles_3years_now]

Hi Deb,

Have you gone back to the surgeon that did the EAR operation.  It sound like maybe he/she hit the nerve,  during the ear suregery! If I were you I'd also get copies of MY medical records from the ear MD as well as the hospital surgical records.  THE TN branch is right behind the ear.  You may need them for a consult with another TN specialist ( oh make sure you get any and ALL x-rays MRI and stuff flims and not just the reports!)

I hated the meds and had a horrible time with side affects and was still having pains.. also getting into see the local Neuro was always at leastan 8 week wait. Too long to be having uncomfortable and un tollerable side affects.  So I just stopped taking them!

I went to see a Dental TN Specialist yestuerday, and he told me that there are MANY new topical forms of many of these meds and that because you do not asorbe much of them, the side affects are greatly reduced.

Right now I use LIDOCAINE opintment for my face and inside my mouth and yes it does help.  I only use it PRN.  

Good luck.