What is this special MRI that shows compressions that I have sporadically heard about? I have another MRI Friday and would like to know if it is the same. It's through the VA so doubtful they would have the budget for something like that.
Thanks,
Mandie
Always wanting to add friends with Type II or their family.
Talk with the MRI center about a FIESTA MRI procedure, also sometimes called a "Trigeminal Protocol". It should be set up for sub-millimeter resolution, and conducted both with and without contrast agent, to facilitate post-procedure 3-D image reconstruction. Not all MRI centers do it, and not all insurance companies are willing to pay for it. But this is the gold standard of imaging for resolution of vascular compressions associated with TN.
Regards, Red
Yes, it's called Magnetic Resonance Angiography. Shows blood vessels, arteries and nerves.
This is what I had...without it, doc's would have been kind of lost.
I just watched a most informative "seminar" by Dr. Michael Lim, Johns Hopkins, and he mentioned the value of having a FIESTA MRI as a diagnostic tool. I tried to get more info on line, but didn't find much-maybe I need to try harder!
Richard A. "Red" Lawhern said:
Talk with the MRI center about a FIESTA MRI procedure, also sometimes called a "Trigeminal Protocol". It should be set up for sub-millimeter resolution, and conducted both with and without contrast agent, to facilitate post-procedure 3-D image reconstruction. Not all MRI centers do it, and not all insurance companies are willing to pay for it. But this is the gold standard of imaging for resolution of vascular compressions associated with TN.
Regards, Red
I just had the Fiesta MRI at Johns Hopkins, I am scheduled for a rhizotomy on the 6th of July, he said it showed a "rubbing" it was about an hour long, first half hour without contrast, then they gave an IV for the contrast. I had to premedicate because I am allergic to contrast, and I had no issues with it. I listened to my iphone music the whole time.
I have a question on this for Red if you see my reply or anyone else, does this MRI show both sides? or is it specific to the pain area? After having it , I now am having pains on my left side.
Wendy
Hi, crashgirl. The imaging of a FIESTA procedure should show the entire brain stem area on both sides of the median line.
Regards, Red
Thanks Red , that just made me relax some, I see Dr. Lim on the 5th and will see what we can do with the left side, but my right side is the severe pain. I was worried I would have to go through it again, I am not good at laying still!!. You are the best!!
Wendy
wendy - you are lucky to see Dr. Lim --- he was my second choice after Dr. Casey -- I've watched every video I could find on either of them before I made my decision!
Thanks KC, I am hoping against hope that he fixes this crap...it was his video that really sold me on him.
Wendy
Hi,
I know these posts are older, but hopefully one of your will read them. I have been diagnosed by 3 neurologists as having TN as well as hemifacial neuralagia. None of the surgeons I have seen are really that familiar with TN. The neurosurgeon I saw feels uncomfortable operating since he feels my diagnosis is atypical. Anyway, I have been debating as to whether I should see Dr. Casey or Dr. Lim. I am leaning towards Dr. Lim because he mentioned the MRI fiesta and also because Dr. Casey had bad reviews online--not here. I would appreciate any advice.
Linda
Linda, I've known Ken Casey for 17 years and talked with him many times. He handles some of the most difficult cases that any neurosurgeon may be called upon to do. He is highly competent and very emotionally well grounded in dealing with patients. I do not know Dr. Lim personally, but he has been well regarded by other members here.
RE: "hemifacial neuralgia". The term is not commonly used and it is quite imprecise. You have pain in one side of your face, perhaps -- but the medical entity would normally be recorded as either glossopharyngeal or trigeminal pain. FIESTA MRI is pretty much the gold standard of imaging to assess whether there is a visible vascular compression of the trigeminal nerve.
Feel free to come back and talk some more. I will be on travel all of tomorrow, but back online over the weekend.
Regards,
Red Lawhern, Ph.D.
Resident Research Analyst, LwTN
Dr. Casey, gave me my life back…I had/have typical but
he treats atypical…he has no requirement for any MRI to find the problem, once he gets his hands inside you, he finds the compression(s)… Been doing this since 1970s…
I would take bad reviews on him , with grain of salt.
I know he has not been able to make 100% of his patients better… But the numbers are very high for reduction of pain, if not long term remission. Dr lim , if Casey retires, if I had to do another MVD… Would be with Dr lim.
I think you have narrowed it down great! Many here are not fortune enough to travel for the BEST.
I researched MVD and these two docs for almost a year, before I emailed Casey, and he personally corresponded , emailed me all the steps, set it up for seven weeks later. Two years later ,still no pain. Most here that are feeling good, have left this site to enjoy life!
Good luck!