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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Neurology
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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I was diagnosed with Trigeminal Neuralga almost to years ago

Customer Question

I was diagnosed with Trigeminal Neuralga almost to years ago this is at UCSF keep the pain away for about 8 months, then a a gamma knife procedure no relief, then a nerve alblation, the last time I saw my Dr. he did not say much I sent him a message 2/25/15 and one on May 18 2015 calls were never returned finally I reached one line told them my pain level over the last 8 months at times it feels like a stroke she assured me a call after the 13th cause of a conference I have listened to Standords Neurology is there is thing that can be done I have been living on nerve blocks sometime they work a few days and sometimes a few weeks
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. P. Jyoti replied 2 years ago.
Hello,
Trigeminal neuralgia can often be difficult to treat.
Since yours is a refractory case, I would suggest a multi - pronged treatment.
The useful treatments for you would be:
Medicines: Drugs like Amitryptiline, Topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Tegretol) are the first line of treatment. You are already on a high dose of Gabapentin but one of these other drugs can be combined with Gabapentin. You should discuss this with your doctor.
If these medicines do not work, there are a number of other steps that can be taken:
Narcotic Analgesics: narcotic analgesics can be given during painful episodes. Drugs like Vicodin can be used for this.
Lidocaine patch: these contain a local anesthetic that you can use in the most painful areas.
Tricyclic antidepressants: drugs like Amitryptiline are combined to give effective relief.
Steroid injections: you are already using these nerve blciks and this should continue.
TENS: electrodes are placed on the skin over the painful areas and are used to relieve pain.
Peripheral Nerve Stimulation: in this, electrodes are inserted under the skin to relieve the pain.
Vit. B and Vit. E supplements: these also help in neuralgia.
Note down these points or copy/paste into Word and take a printout and discuss with your doctor. This will enable an informed discussion and help you to get detailed explanations. Ask about these treatments and whether they are possible for you. This can lead to a solution for you.
Hope this shows you the way forward - wish you good health and a quick recovery.
I trust my answer has helped you gain more knowledge and confidence about your problem and in knowing what to discuss with your doctor.
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If you have any other questions, please ask me – I’ll be happy to respond. Bonus is always welcome - Thank you!
Dr.P.Jyoti, MD.