Eileen said:
Ronald I am so happy for you...you have your life back now.How long ago did you have the nerve block procedure? What is it called? Where are you based? Did you have ATN or TN? Thanks!Eileen, I have ATN. The nerve block is called "Trigeminal Nerve Block".It seems the terminology varies with the clinic, hospital or medical practice so it is best to start a discussion for clarity. I have had SPG nerve blocks at Cedars-Sinai Pain Center in Los Angeles twice under general anesthesia with no success but left after two hours because I was an out- patient. My trigeminal nerve block was done four years later in the doctors office on 29 October 2015 as an out-patient ( I left two hours later).My pain relief has already worn off but the doctor had already explained that they typically concentrate on finding the correct location of the three trigeminal nerve branches using a low dose injection then confirm patient reported pain relief before a second nerve block because the nerve block effects tend to accumulate. They require the patient to wait two weeks and report pain level changes before they will schedule the second stronger nerve block. In addition, the anesthesiologist gave me a low dose general anesthetic because the doctor usually wakes the patient after the needle tip is through the cheek and at the trigeminal nerve. He then moves the needle tip and applies a low voltage stimulation and asks the patient if this stimulation is felt where pain occurs. When the low level stimulation matches the patient reported location then the patient is put back to sleep to complete the procedure. See this video òf the technique done by Mayfield Clinic at www.youtube.com/watch?V=NioxbJ7OyKl and also available at www.mayfieldclinic.com under the title of Percutaneous Procedures for Trigeminal Neuralgia. As you will soon notice on YouTube there are many other doctor videos on percutaneous procedures or needle through the cheek to the nerve. These procedures can vary from a simple nerve block injection of lidocaine or marcaine that causes no nerve damage to rhizotomy which is nerve destruction using various techniques such glycerol injection, RF thermal heat ablation, Balloon comression, etc. The procedures are typically done with nerve block first then successively more nerve destructive procedures as needed to reduce pain with minimum loss of nerve functions that could cause loss of facial muscle control. The goal is to trade pain for the minimal numbness. Hope this helps.By the way, my doctors at Neurological Associates of West LA ( www.naowla.com ) are or have been resident doctors at UCLA Neurological Institute. We are also discussing minimally invasive or percutaneous pulsed RF therapy that does not cause nerve damage like continuous RF rhizotomy where the RF is left on to heat the needle and burn the nerve ( called RF THERMAL rhizotomy by most doctors ). As another non-destructive option they also offer ketamine infusion. However, unlike most ketamine infusions which require in-patient or hospitalization for three or more days they do a lower dose out-patient IV in their office and send you home with someone to watch because bad dreams often occur. Then they do another treatment for the next two days and you spend the night at home each night. Sometimes, the two hour in office IV procedure is done at a surgical center depending on the availability of the anesthesiologist. These doctors are claiming much better, longer lasting results using their initial low dose ketamine infusion then titrating up depending on patient response rather than the typical procedure of very high dose every day. It is good to see doctors who talk about their successes with other TN patients.
