In the days of yore when patients did not know what caused it and it had no cure and the disease drove many to commit suicide. Awareness of Trigeminal Neuralgia (TGN), considered to be among the most painful of conditions of mankind is still very low. Those with the disease and their families suffer a lot because it is probably one of the worst types of pain known to man.
It is for this very reason TGN, though it is very rare, has a day in the year, October 7, designated to raise awareness about it.
Pain Management Physician and anaesthesiologist C.H. Murali Krishna said that the Trigeminal Nerve was the longest nerve in the brain.
In the typical TGN, the patients suffer episodes of severe, sudden shock (electric) like pain in one side of the brain that lasts a few seconds to a few minutes. The compression from a blood vessel as the nerve exits the brain stem is the common cause for the disease. Multiple Sclerosis, stroke and trauma were also common causes of the disease. Tumours and malformation of arteries and veins were also less common causes, Dr. Krishna said.
Microvascular decompression
While drugs and surgery were the only treatment earlier now there were new therapies available, he said. Microvascular decompression (MVD) which involved the placing of a teflon piece between the nerve and blood vessel interventionally was a new treatment.
The other was desensitising of the nerve causing the pain through radio-frequency ablation. Balloon decompression in which a balloon was placed between the nerve and blood vessel was an alternative to MVD. This was also done interventionally. Gamma Knife was an alternative to radio frequency ablation, but that was not available in Vijayawada, Dr. Krishna explained.
There were patients who suffer for years and sometime for decades because they had little idea about what was causing the pain. Any pain that lasted for more than three months was considered chronic pain, he said.
Interventional medication applied with the help of C-Arm or CT-Scan and also radio-frequency ablation were new developments in pain management.
Administering pain medication interventionally was more effective in reducing inflammation. It was more effective in ultimately reducing inflammation and also the dosage of the pain-killers that caused severe side-effects after prolonged use, Dr. Krishna explained.
These pain management therapies that were earlier available only in Hyderabad and Chennai were now available in Vijayawada, Dr. Krishna said.
