How Much Trigeminal Neuralgia Pain Before Seeking Surgery (side, nerve, procedure)
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I've had Trigeminal Neuralgia (TN) intermittently for a few years and and continuously for the last year.
I've been taking lamotrigine during this past year, and my pain has responded reasonably well to this medication. I had an MRI in May, and I'm told that the artery that is interfering with nerve is highly visible in the MRI image, thus making me a good candidate for microvascular decompression (MVD) surgery.
My question relates to how much remaining pain would warrant pursuing MVD. One source told me that any remaining pain tended to indicate that the meds were insufficient, and that I should pursue surgery. Another source was less adamant and suggested that there would inevitably be a balancing test between my ability to tolerate the amount of remaining pain and any risk arising from MVD surgery.
I'm writing to see if anyone has faced this decision in the past, and what advice you'd give in this situation. Otherwise stated, does the presence of any amount of remaining pain warrant pursuing surgery? Or, would you accept some degree of discomfort to avoid any risk from surgery?
Last edited by Voyager39; 10-14-2021 at 02:18 AM..
Short answer-- It's your pain. Only you can say if it's time for something new to deal with it.
TN is a nasty condition. You're already a hero for putting up with it for so long. No tx is perfect for everyone.
Most cases have no obvious anatomical cause-- they're best considered to be seizures of the trigeminal nerve. If your case suggests a remediable anatomic cause (the enlarged artery) and the medical tx is less than perfect, then perhaps surgery is a wise choice. It's a safe and often effective procedure. https://pubmed.ncbi.nlm.nih.gov/8598865/
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