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Treatment of Tertiary Neuralgia

 

The treatment of tertiary neuralgia (TN) consists of several approaches: drug therapy, surgery, and pharmacological treatments. In addition, there are various MVD treatments. Read on to learn more. TN is characterized by periodic periods of complete remission, which may last for months or years. The cause of these periods is thought to be reduced excitability and partial remyelination.

pharmacological

Pharmacological treatment of TN is often recommended for patients who are experiencing pain of various types. Lidocaine, 5 mg/kg every 60 min, significantly reduced pain intensity in a placebo-controlled trial. In addition, NMDA receptor agonists may also be effective in treating TN. The treatment of TN depends on the type of neuropathy. Patients with classical TN may respond to anticonvulsant drugs. Ablative procedures and microvascular decompression should be considered if pharmacotherapy fails.

In addition to pain caused by a damaged nerve, a weakened nerve can also cause this condition. Pressure and infection can also cause pain, as can changes in a person’s nerve’s function. One common infection that can affect a nerve is shingles, a chickenpox virus infection. Age-related conditions can increase the risk of developing shingles. A nearby nerve may also be affected by a virus.

surgery

Surgical treatments for tertiary neurogenic pain are available for sufferers with severe forms of the disease. This procedure involves inserting a small balloon into the affected nerve, which causes controlled intentional nerve damage. The nerve no longer sends pain signals to the brain, and the effects usually last for 1-2 years. However, if you’re concerned about your condition, you should discuss all your options with your doctor. You may also want to seek the advice of a pain management specialist.

While surgical interventions for TN are not generally considered necessary, they are sometimes used in the event that medical therapy fails to provide adequate pain relief. These procedures are not useful in preventing severe exacerbations and should be reserved for patients who have not responded to nonsurgical treatments. Some patients may request a surgical procedure due to a fear of the pain returning or progressing, or even side effects from medications.
drug therapy

Treatment for tertiary neuropathy may consist of different types of drugs. Carbamazepine, an antiseizure drug, is the initial treatment of choice for patients suffering from trigeminal neuralgia. Typically, the dosage ranges from 200 to 1200 mg per day, and it neutralizes hyperexcitable neural membranes. However, there are several side effects associated with carbamazepine, including drowsiness and ataxia. Patients must also monitor their complete blood count closely while on the drug, so it is important to discuss the treatment options with your doctor before starting it.

Patients with trigeminal neuropathy were seen monthly until a target dosage was reached and a significant reduction in pain was observed. After this initial treatment, patients were followed every six months until side effects occurred. Patients were evaluated by two staff members who underwent neurophysiological tests and clinical examinations to confirm a diagnosis of classical trigeminal neuralgia. The treatment was successful in reducing the pain in 80% of patients.

MVD

One option for treating TN is through surgery, and MVD is one of the most common surgical procedures. This procedure is invasive, but it provides the highest chance of permanent relief for patients with this condition. The surgeon makes an incision behind the ear to expose the trigeminal nerve and then moves arteries that compress the nerve with a microscope. Afterward, the physician places a pad between the nerve and the arteries. After MVD, patients remain in the hospital for several days.

MVD is a surgical procedure that is performed by making a low-lateral retromastoid craniectomy. The surgeon makes an incision from the iniomeatal line to the inferior mastoid tip, about 0.5 cm behind the patient’s hairline. The craniectomy is then extended to the floor of the posterior fossa, exposing the sigmoid sinus. The craniectomy is completed by making a T-shaped or curvilinear incision in the dural wall.