In October 2004, I went to the dentist for a root canal and ever since I've had a condition called trigeminal neuralgia (TN), a neuropathic disorder of the trigeminal facial nerve which causes "stabbing, mind-numbing, electric shock-like pain". For a long time, we had no idea what was wrong with me. I had three dental surgeries and a molar pulled before I decided the pain was not going to be helped by dentistry. Apparently, this is common amongst TN patients. After seeing many doctors, including an otolarynologist, I finally made it to a neurologist who quickly gave my pain a name.
I was happy to learn that TN is considered one of the most painful diseases to have; now, I didn't feel like such a wimp for feeling so bad. For five years it has hurt to brush my hair, brush my teeth, wash my face, eat, smile, laugh, live. TN is called the "Suicide" disease because so many with the disorder end up killing themselves. As I type this, it feels like a screwdriver is being jammed into my left ear - and I've only just woken. I lightly scratch an itch above my lip and the pain spreads there. As the day progresses, the pain will spread and get worse.
My neurologist is using the typical treatment for TN: anticonvulsants and opiates. Unfortunately, it is difficult to have a good life with these medications, especially in the large doses I'm prescribed. I have also gotten to the point where the opiates no longer control the pain. I have to take another option: Microvascular decompression.
So, next Friday, my surgeon, one of the best in the world, will cut a small hole in my skull behind my left ear and attempt to isolate the trigeminal nerve. If it appears that isolation is not going to be helpful, the surgeon will damage the nerve.
Patients are put to sleep using general anesthesia and are positioned on their back with their head turned or on their side with the symptomatic side facing up. Electrical monitoring of facial function and hearing is used. A straight incision is made two finger breadths behind the ear about the length of the ear. A portion of the skull the size of a half-dollar is removed exposing the underlying brain covering known as the dura. The dura is opened to expose the cerebellum. The cerebellum is allowed to fall out of the way exposing the side of the brain stem. Using a microscope and micro-instruments, the arachnoid membrane is dissected allowing visualization of the 8th, 7th and finally the trigeminal nerve. The offending loop of blood vessel is then mobilized. Frequently a groove or indentation is seen in the nerve where the offending vessel was in contact with the nerve. Less often the nerve is thin and pale. Once the vessel is mobilized a sponge like material is placed between the nerve and the offending blood vessel to prevent the vessel from returning to its native position.
After the decompression is complete, the wound is flushed clean with saline solution. The dura is sewn closed. The skull is reconstructed and the overlying tissues are closed in multiple layers. The patient is allowed to wake up and is taken to an intensive care unit or other close observation unit.
Here is a three-minute TV news report explaining TN:
Oh, I am so sorry for what you have been going through. I will be praying for you! I have had horrible migraines since I was 16. I can't imagine anything worse, but this definitely sounds worse. I have never heard of TN. I hope you are feeling better soon!
I just had dinner with my Brother-in-law and he said his wife has been diagnosed with TN and they are waiting for the scheduled surgery. I watched the video of the surgury...it was interesting. I understand some of the pain issues as I have had chronic pain for 25 years and this scares me. My prayers are with you.
i am being treated by a doctor in fairfield, ct for trigeminal neurology with auricular therapy. she has diagnosed and has helped me so much after five years of pain in my upper right gums. i had two teeth pulled for nothing! please look into auricular therapy before going into surgery. it may help you as much as it has helped me.
I have had tn for 30 years and control it by taking
Tegretol-2(200mg) 12times daily. I started out by taking 2 a day and progressed over 30 years. However I get about 80 to 90% relief.
actually, an experience dentist should recognize Trigeminal Neuralgia and decide NOT to do A Root Canal Treatment or tooth Extraction, the important thing is History taking, Patient Explannation what kind of pain is.
I hope your surgery went well. I'd like to know how it went, if you'd like to share. I am 44 years old and my 70 year old mother has battled TN for the last 40 years. She is currently in the hospital fighting her latest battle. She has had all the surgeries possible with no success. In fact in 1996 she lost the hearing in her left ear due to the surgery. On average, she has a battle with it every 5 years. It causes hospitalization for about 2 weeks. I hope things were successful for you. If you have continued research on TN and have discovered anything new, I'd appreciate hearing about it. If not, I'd love for you to keep praying for others with TN.
hi.. i have only been suffering with tg for a yr..but i can not go to work or go out or plan anything with friends.. i am a shutin now.. i want my life back...i am in canada and the 1 specialist i seen basically said i had to live with it.. i want this fixed so i can go back to my work..i do have a pain managment app. in march.. but am so tired of pain pills and not doing anything.. anyone can help please email me at kittykitty10@hotmail.com.. thank you
I am so sorry you have this. I have it from nerve damage due to shingles in my ear and cranial nerves. They cannot fix it. I hope they can fix your condition. I have read about good results with your type of cause (dental). You are in my prayers.
Hi I had that surgery back in 2008, and it saved my life. I lived with TN for over 6 years, it effected the entire right side of my face. I finally go the point where I could not handle it anymore and typed in "ready to off myself can't handle the pain anymore" and the name Dr. Kenneth Casey popped up. I went to him the next week and he reviewed my MRI and explained the surgery, i was scared so i said not yet, 6 months later i had another major attack and had the surgery, it was the best thing i could've done, since 10-16-08 I've had my life back. If you would like more information let me know. God Bless
I tried leaving a comment on a later blog,but something is wrong. Hopefully, it will take here.
I've had TN for 3+ years, and next week I'm going to the
http://www.coloradocyberknife.com/
for their procedure.
Would you like me to tell you how it turns out? I hope you are doing better.
I tried leaving a comment on a later blog,but something is wrong. Hopefully, it will take here.
I've had TN for 3+ years, and next week I'm going to the
http://www.coloradocyberknife.com/
for their procedure.
Would you like me to tell you how it turns out? I hope you are doing better.
My wife has seen Dr. Jeffery A. Brown and he did brain surgery to insert a teflon pillow between the blood vessel and the TN nerve. Once in the brain, however, he found another place upwards of the insision site, where several blood vessels were squeezing a nerve, so he cushioned that also.
i am a newcomer to the condition; it started as what seemed to be toothache a month ago and this morning at 1 am i was in utter agony. so its picked up to that point from being mild to unbearable in a matter of weeks. it flares up really fast then lingers, dies down and comes back. but its there all the time now. its the weirdest thing to try and explain to people. most just shrug and smile as if to say, "yeah, its all in your imagination mate". as we say in south africa "really kak"