Mri

General General TN & GPN (Old Site)
1

hi the neurosurgen saw my report from my mri in new york and said that he did not see anything there. he said that i did not have trigeminal neurolgia. i am so confused i was told by neurologist that the mri usually comes out normal? i have the sypmtoms of tn. what do i do next? thanks michelle

2

Which neurosurgeon did you see?

3

i did not see him the faxed the report to him his name is philip steig.

4

I am in NY.

I will let the more experienced people answer but I thought that TN not seen by a compression on an MRI is called idiopathic, but still TN?

5

I have had countless MRI's since being diagnosed with Trigeminal Neuralgia in 2008 and all I have come back with not showing compressions. I had my first MVD which found a vein wrapped around the nerve and an artery pressing on it, the MRI before the surgery showed no compressions. I had 2 MRI's before the my second MVD and both showed no compressions yet the surgeon found compressions on my 7th, 9th and 10th cranial nerve. It is typical to have a clean MRI and still have TN.

6

Jessy's experience is fairly common. TN is diagnosed on the basis of pain patterns and medical history. AT BEST, MRI can be a confirmation of the condition. Likewise, not all MRI's are created equal. The Gold Standard of practice for this disorder is a sub-millimeter resolution FIESTA procedure performed both with and without contrast agent, and with post-procedure 3D processing for visualization. And even that procedure misses about 10-15% of compressions that are confirmed during MVD surgery.

Regards, Red

7

Jennifer, the term "Idiopathic" signifies "arising spontaneously or from an obscure or unknown cause" . This term is often applied to both Type I and Type II TN, when MRI shows no explicit compression (or sometimes when pain is unresponsive to Tegretol or Oxcarbamazepine). But if you have the symptoms, then you have the disorder. For an expansion of symptoms and overlaps between disorders, see http://www.livingwithtn.org/page/face-pain-info-pages-part-2a

Regards and best,

Red

8

Thank you for the clarification. This is helpful.



Richard A. "Red" Lawhern said:

Jennifer, the term "Idiopathic" signifies "arising spontaneously or from an obscure or unknown cause" . This term is often applied to both Type I and Type II TN, when MRI shows no explicit compression (or sometimes when pain is unresponsive to Tegretol or Oxcarbamazepine). But if you have the symptoms, then you have the disorder. For an expansion of symptoms and overlaps between disorders, see http://www.livingwithtn.org/page/face-pain-info-pages-part-2a

Regards and best,

Red

9

thanks so much for all your info and support. michelle

10

i found another neurosurgen in new york his name is dr babu has anyone heard of him? thanks michelle

11

Which hospital?

12

Dr. Babu has received favorable comment from several members at Living With TN, Michelle.

Regards, Red

13

we have a favorite doctors page on here somewhere --- keep posting if you need help!

14

I googled him - he has good reviews there as well.

15

Michelle, I see our Living with TN family pointed you in the right direction. Getting the right neurologist is so critical to the diagnosis and proper treatment of TN. Red's recap on the different MRIs is very helpful & thorough. I had one that didn't confirm anything, but my neuro still treated the TN properly. I went to a neuro surgeon about MVD and I had the sub-millimeter resolution FIESTA MRI with contrast die(1 hr 20 minutes in the chamber). They did find the compression, but I decided against the surgery. I hope your new neuro will help you get the best treatment for your TN. Take care.

Jim