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Surgery can help trigeminal neuralgia

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Trigeminal neuralgia (also called tic douloureux) is sometimes a symptom of multiple sclerosis and is often extremely painful. It tends to come and go unpredictably in sudden shock-like attacks that usually affect one side of the face.

Initial treatment is with drugs and people are often advised to avoid any triggers that set the pain off. Sometimes surgery is used if drugs do not work. However, surgery can leave the face feeling numb because it works by damaging the trigeminal nerve in the face.

This study looked at a particular kind of surgery called percutaneous balloon compression (PBC). A needle is inserted under local anaesthetic and a small balloon is used to compress the nerve. The resulting damage stops the electrical activity in the nerve which reduces or stops the pain.

The cases of 21 people with MS who had already received PBC for trigeminal neuralgia were reviewed. All had either an excellent or a good outcome with a single or repeated procedure. The factors which helped most were having only one branch of the trigeminal nerve affected, not having had previous surgery and using a short compression time and/or a pear-shaped balloon during the procedure.

The researchers concluded that PBC is a safe and effective treatment for trigeminal neuralgia when drug treatments have not worked.

Montano N, Papacci F, Cioni B, et al.
Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis.
Acta Neurochir (Wien). 2012 Feb 22. [Epub ahead of print]

You can read more about trigeminal neuralgia in the A-Z of MS.

Research by topic areas...

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A randomized, placebo-controlled trial of levetiracetam in central pain in multiple sclerosis.
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Drugs in development

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Daclizumab use in patients with pediatric multiple sclerosis.
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Other treatments

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Arch Phys Med Rehabil. 2012 Jan;93(1):96-9.

Robson P.
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Expert Opin Drug Saf. 2011 Sep;10(5):675-85.

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Walker LA, Berard JA, Berrigan LI, et al.
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Patten SB, Williams JV, Lavorato DH, et al.
Health status, stress and life satisfaction in a community population with MS.
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Physical activity

Sitjà Rabert M, Rigau Comas D, Fort Vanmeerhaeghe A, et al.
Whole-body vibration training for patients with neurodegenerative disease.
Cochrane Database Syst Rev. 2012 Feb 15;2:CD009097.

Motl RW, Smith DC, Elliott J, et al.
Combined training improves walking mobility in persons with significant disability from multiple sclerosis: a pilot study.
J Neurol Phys Ther. 2012 Feb 13. [Epub ahead of print]

Other demyelinating conditions

Ketelslegers IA, Catsman-Berrevoets CE, Neuteboom RF, et al.
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J Neurol. 2012 Feb 17. [Epub ahead of print]


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Rev Recent Clin Trials. 2012 Feb 1. [Epub ahead of print]

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