November 28, 2017
Trigeminal Neuralgia (TN) is universally considered as worst pain known to mankind and is nicknamed as ‘Suicide Disease’. It is brutal, relentless condition; more painful than kidney stones, giving birth or a heart attack.
Trigeminal Neuralgia is a disorder of the trigeminal nerve in the face which results in its overreaction to everyday stimuli, such as talking, eating and light touch.Trigeminal Neuralgia is caused in 50% patients with blood vessel pressing on the trigeminal nerve, 10% of patients with multiple sclerosis, secondary tumors or Injury to the trigeminal nerve. In about 40% patients there are none of the above reasons and the disease is then categorised as Idiopathic Trigeminal Neuralgia. The pain of this condition may range from a sudden, severe, and stabbing to a more constant, aching, burning sensation. The pain may affect a small area of the face or may spread gradually to one side of the face. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. Eventually, the pain-free intervals disappear and medication to control the pain becomes less effective. The disease is more common in elderly patients aged between 50-70yrs. And the incidence is 5.2 per 100,000 females and 3.0 per 100,000 males.
This is the story of Mr. IK (Name changed), 83 year old gentleman who had symptoms of a pain which started initially when he was 68 yrs old on left face while he was brushing his teeth. A dental consult was normal. As the weeks went on, brushing his teeth became nightmare, every second bite he takes he was writhing with volleys of shocking pain shooting through the roots of the tooth on the left side. He feared to shave, clench his teeth, smile or travel. He was started on pain medications for Trigeminal Neuralgia by local neurologist. The medication initially started with one drug and after 10 yrs he was taking 3 drugs at peak doses for pain control. He was unable to tolerate the side effects of this medication which included vomiting, dizziness, drowsiness, loss of balance, swollen tongue with passing days. At 78yrs he underwent radiofrequency ablation therapy. He had remission for a brief period of 3 yrs though followed by severe pain recurrence over last 2 years and was put back on high doses of medications which he could not tolerate.
Unable to bear the persistent severe pain Mr.IK approached HCG – The specialist in Cancer Care where after looking at Mr.IK medical history and the reports of treatments he had undergone over the span of 15 years, Dr. Shankar Vangipuram , a Radiosurgery Expert in the management of Trigeminal Neuralgia at HCG Cancer Center, Mumbai decided to treat him with Stereotactic Radiosurgery (SRS).
Radiosurgery is a surgery using radiation i.e. destruction of the precisely selected areas of the tissues using ionising radiation rather than excision with blade. Conventionally, a condition like this can be treated using several platforms using X-Knife, CyberKnife ,or Gamma knife that typically takes about 27-90mts to deliver the treatment. But in a path-breaking achievement in treating Trigeminal Neuralgia, with the right mix of advanced FFF Technology & Robotics, Dr. Shankar and his team successfully delivered the treatment in just 23.7 minutes, which is recorded to be the shortest duration to treat a condition of Trigeminal Neuralgia.
Mr.IK is now back to his routine life without any medications & performing his daily chores with ease with no symptoms of recurrence or side effects.