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Dr. Andrew Rynne
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Dr. Andrew Rynne

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How Can Painful Atypical Trigeminal Neuralgia Be Treated?

Hello sir,, my wife is suffering from atypical trigeminal neuralgia from six months. She had a very pain in right part of face. No medicine is effective in controlling her pain. She is taking oxmazetol but no effect on pain. Doctors advice us for two surgeries . it is my humble request plz suggest us an appropriate drug.
posted on Sat, 9 Jul 2016
Twitter Tue, 15 Oct 2019 Answered on
Twitter Thu, 17 Oct 2019 Last reviewed on
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General Surgeon,  's  Response
Hi,

Noted the history about your wife having trigeminal neuralgia not amenable to Oxmazetol, Doctors advising 2 surgeries.
Pain in the right side of face is surely indicative of trigeminal neuralgia that should have responded at least partially to the said medicine.
Hence it is important to get the correct diagnosis which can also be due to sinusitis, dental abscess and so on.
Hence I would advise her the following:
Consult ENT Surgeon first to have proper clinical evaluation:
CT scan for sinuses to rule out sinusitis and other causes.
MRI for Trigeminal Nerve, any vascular abnormality over the Nerve.
Get a second opinion of a Neurologist if needed.
The treatment would be as per the cause found.
If the blood pressure is elevated causing the arterial loop over Trigeminal Nerve to cause pain then proper 24 hour control of blood pressure is needed.
Change over to other medicines like Tryptomer, Gabapentin and so on.
Surgery is advised only if indicated by MRI studies.
Ablation of Trigeminal Nerve was done in old days.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, General Surgeon
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How Can Painful Atypical Trigeminal Neuralgia Be Treated?

Hi, Noted the history about your wife having trigeminal neuralgia not amenable to Oxmazetol, Doctors advising 2 surgeries. Pain in the right side of face is surely indicative of trigeminal neuralgia that should have responded at least partially to the said medicine. Hence it is important to get the correct diagnosis which can also be due to sinusitis, dental abscess and so on. Hence I would advise her the following: Consult ENT Surgeon first to have proper clinical evaluation: CT scan for sinuses to rule out sinusitis and other causes. MRI for Trigeminal Nerve, any vascular abnormality over the Nerve. Get a second opinion of a Neurologist if needed. The treatment would be as per the cause found. If the blood pressure is elevated causing the arterial loop over Trigeminal Nerve to cause pain then proper 24 hour control of blood pressure is needed. Change over to other medicines like Tryptomer, Gabapentin and so on. Surgery is advised only if indicated by MRI studies. Ablation of Trigeminal Nerve was done in old days. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon