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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5122
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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Tegretol seem to work in day time but no inthe evening JA:

Customer Question

Tegretol seem to work in day time but no inthe evening
JA: OK. The Neurologist will need to help you with this. Please give me a bit more information, so the Neurologist can help you best.
Customer: i have tn attack for a week.
I had tn diagnosed 2 years ago and 499 mg worked fine.
JA: Anything else I can tell the Neurologist before I connect you two?
Customer: Now the attacks are much more severe, 600mg of Tegretol a day works until the evening then stops.
JA: I'm sending you to a secure page on JustAnswer so you can place the $5 fully refundable deposit now. While you're filling out that form, I'll tell the Neurologist about your situation and connect you two.
Submitted: 7 months ago.
Category: Neurology
Expert:  Dr. Bob replied 7 months ago.
Hi there. Have you discussed this with your doctors? Breakthrough pain may indicate a progression of your condition. If you have not already had an MRI, I would suggest you ask your doctor about ordering one.
Expert:  Dr. Bob replied 7 months ago.
TN can be caused by a variety of conditions, some more serious than others. For example, it may be the result of a blood vessel pressing on the trigeminal nerve as it exits the brain stem. This compression causes the wearing away or damage to the protective coating around the nerve (the myelin sheath).
Expert:  Dr. Bob replied 7 months ago.
TN symptoms can also occur in people with multiple sclerosis, a disease that causes deterioration of the trigeminal nerve’s myelin sheath. Rarely, symptoms of TN may be caused by nerve compression from a tumor, or a tangle of arteries and veins called an arteriovenous malformation.
Expert:  Dr. Bob replied 7 months ago.
An MRI may help to rule out such causes, or the progression of a previously diagnosed cause.
Expert:  Dr. Bob replied 7 months ago.
In the meantime, control of pain in TN can be maintained in most patients with 600 to 800 mg daily. However, some patients may require as much as 1200 mg daily. Talk to your doctor about whether or not an increase in your Tegretol is indicated at this time.