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Greater awareness needed on trigeminal neuralgia

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Grateful: K.G. Hospital Chairman G. Bakthavathsalam (second left) with Santokben Gala (second right), who underwent a balloon compression procedure to treat trigeminal neuralgia. Neurosurgeon M. Natarajan, who performed the surgery, is in picture (right).
Grateful: K.G. Hospital Chairman G. Bakthavathsalam (second left) with Santokben Gala (second right), who underwent a balloon compression procedure to treat trigeminal neuralgia. Neurosurgeon M. Natarajan, who performed the surgery, is in picture (right).

Special Correspondent

COIMBATORE: Santokben Gala (69) from Gujarat keeps smiling throughout nearly an hour-long session at which neurosurgeon at K.G. Hospital here M. Natarajan explains the disease she had been suffering from for 10 years. She could not smile or eat normal food for four years. The smile was restored after a balloon compression procedure done at the hospital only recently.

Till then, Mrs. Gala was among those traumatised lot who did not know about the disease – trigeminal neuralgia – that triggered a searing pain across the face. It is nicknamed “the suicide disease” as the lack of awareness and the consequent inability to diagnose accurately and in time leads to the patients getting desperate to end their life.

Trigeminal neuralgia is a sharp pain that occurs on the face because of a nerve that travels from the lower jaw to the brain is affected. Dr. Natarajan says that an exact cause is not known. But, vascular (nerve) compression is one of the probable causes.

Most of the affected people initially think there is a problem with the teeth because the nerve originates from the lower jaw.

“When the disease is finally detected, most of the patients may have already undergone root canal treatment and even parted with some teeth,” says Dr. Natarajan.

Asked why the pain was misconstrued as one caused by a dental problem, the neurosurgeon explains that the nerve travels from the dental region. “Besides, who does not have a dental problem nowadays?” So, without knowing that it is actually trigeminal neuralgia, the disease is quickly associated with an existing dental problem.

Mrs. Gala was no exception to this lack of awareness, he says. Her husband Vasanji N. Gala says: “I now see a smile on my wife’s face for the first time in four years.” The last four years were so agonising that her face could not even break into the faintest of smiles.

She felt that her face was being torn apart. This lasted for a few seconds initially. It became incessant over the last one year as the disease worsened.

Mr. Gala, a transcendental medicine (mediation) expert, tried out all other forms of treatment for his over the last 10 years, but nothing worked. His daughter in Mumbai surfed the net and found on K.G. Hospital’s website an explanation of a disease similar to what her mother suffered from. A discussion with the hospital brought them to Coimbatore.

Dr. Natarajan performed a balloon compression procedure (Percutaneous Trigeminal Ganglion Balloon Compression). A wide bore needle was passed from the cheek to the trigeminal cave. A balloon catheter was inserted into this region and the balloon was inflated to compress the affected region to provide relief from pain.

Chairman of the hospital G. Bakthavathsalam says performing this technique requires a great amount of skill. A slight error can damage an artery or cause a stroke.

Dr. Natarajan says the balloon compression technique is 14 years old and it takes four to five years to perfect it. If it does not work on some patients, an open surgery will have to be performed.

While the technique is not new, a majority of the people do not know about the disease and these include physicians who associate the pain with a dental and not a neurological problem.

“A greater level of awareness is needed for early treatment,” he says. “Otherwise, people suffer in pain. They cannot even eat,” says Dr. Bakthavathsalam.

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