Two of the most interesting things I heard about TN pain treatment are the following. Dr Marshall Devor, doctor in this case being PhD, is doing some of the world's leading research on neuropathic pain. He is also leading the TN genetics study. His research is showing that medication really does not work for nerve pain beyond a placebo effect. He feels that the best medication for nerve pain depends on finding the gene that causes the pain, and then creating a drug that targ...ets the gene. He also pointed out that nerve pain is actually and I quote, " Neuropathic pain is a disease of faulty regulation of neuro excitability." This explains why over 71% of the human population have compressions against the 5th cranial nerve, but few will feel pain from it. Both Dr Devor, and Dr Kim Burchiel, head of the neurosurgery department at OHSU, commented TN pain starts at the dorsal ganglion, and that if there is to be a cure for TN that is where the research needs to be done. As for the use of marijuana for TN pain, the jury is still out. I agree with Dr Devor, that past a placebo effect, it has done little to reduce my TN pain outside of taking the edge off the pain, and the pot induced giggles I get sure beat wanting to rip the left side of my face off. Yes, he asked if I had tried pot for TN pain, and I answered him honestly. I get funny looks when I tell people I was 48 yrs old when I smoked pot for the first time, and this time was no different.
Unfortunately for Dr Devor's premise, there is a well established track record for multiple anti-seizure medications as effective means of managing typical TN pain. Trigeminal neuropathic pain (sometimes called atypical TN) is a tougher proposition, but many patients get assistance from the tricyclic antidepressants, with success rates exceeding placebo.
As for the dorsal ganglion, I believe multiple research studies are focused on that area and there may be some merit in the assertion that TN pain starts there.
Regards, Red
I was already on 2600 mg a day of Neurontin, when I was diagnosed with Typical TN. The tricyclic antidepressants you mentioned did not work for me. I respect everyone responds to medications differently, but over all they did not work for me, that is why I went ahead with surgery.