Based on my pain and its pattern I have Type 1 TN. It seems the next step is to rule out a tumor and then try meds. Without insurance I need to be efficient with tests and dr. visits. What sort of scan is recommended based on cost and benefits?
Unfortunately, cost is NOT, NOT, NOT a useful measure of utility for this sort of thing. The recommended scan might cost you on the order of $2 thousand dollars: FIESTA MRI procedure done with and without contrast agent for sub-millimeter resolution with a focus area on the brain stem. Not all MRI centers do it, but it is the gold standard of care for assessing whether you have vascular compressions, small tumors, cysts, AVMs or other structural anomalies. CT scan is sometimes used at lower cost, but isn't nearly what you need to clearly establish whether you are a good candidate for MVD.
Regards, Red
Thank you very much for your succinct info. I would rather spend the 2000 and find out what is what. My PCP is insisting that I come back to her again. Would you suggest I just request she order this test for me or will she need to send me to a neurologist to order it, a referral which will likely take months? What if she suggests a CT scan first? Should i go along with that, and would that at least rule out a tumor so that we might then try anti-convulsants and pain meds?
Ruling out Tumor is of course wise. But the FIESTA MRI will do that too. And you may need one in order to prepare the way for eventual MVD surgery. Since that's true, you'll probably end up with more total cost if the CT scan is done first.
Many neurosurgeons won't concur in recommending MVD without MRI evidence of compression. Your PCP should be able to order the procedure. But she may not have sufficient training to be good at managing your neurology care. Referral to a neurologist would be much preferred, if you can find one that will take you as a patient. Check the doctors tab on our menu for recommended physicians.
Regards, Red
Thank you very much. What you say makes sense. There are no recommended drs. in my area. But there is a good-sized neurology practice and I will be trying to find which dr. has the most experience with TN and whether the hospital does FIESTA MRIs.
I very much appreciate your input, and this site.
Is a "Tessla" MRI adequate or comparable? Apparently that is what is offered at my hospital.