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Joined: 6/11/2009
Posts: 1
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My AN was diagnosed 4 years ago. It's small enough to "watch and wait." However, a year ago the TN started and now I need 1000 mg a day of Carbamazapine just to keep the pain at a 5 level. When I eat or talk, after a few minutes I feel as though someone is putting a live wire on my bottom molar (same side as AN) I'm operating under the assumption that the AN has been irritating the TN nerve all along and that symptoms have just now shown up, and that if I get rid of the (small, under 2 cm) AN the TN will go away. If I opt for surgery on the AN, hopefully to get rid of the TN, is Cyberknife the best option for this scenario? Or will a cut-into-the-head approach like the trans-lab be best?
Sharon N
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Joined: 10/10/2008
Posts: 1435
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Tough question to answer without seeing the images. AN's only cause TN in about 5% of cases. We see that more often with meningiomas. But it can happen with either. What little data we have suggests that the TN is usually improved with treatment of the tumor. In a few cases, we have treated the tumor and not gotten pain control and gone back and treated the trigeminal nerve like we usually do for TN.
In this case, assuming there is nothing unusual or unexpected on the scans, we would probably treat the tumor in standard fashion, and if the TN pain did not improve consider treating it. That is really no a very high dose of Tegretol and you could go much higher under medical supervision if you are tolerating it well.
I really have to emphasize the importance of viewing the images in this before making any decisions, because details are important.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 10/10/2008
Posts: 1435
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I answered this the other day, but somehow my post did not appear.
Frequently, TN pain goes away with treatment of the tumor, even without much if any identifiable tumor shrinkage. Therefore, in this situation we usually offer the radiosurgery and reserve surgery for failure to control the symptoms. Also, in some cases, it is possible to treat the nerve for pain control if treatment of the tumor does not work.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 11/6/2008
Posts: 6
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General question....if CK can be used to treat the nerve that causes TN...can it also be used for say someone with chronic back pain? just curious... C
3cm vidian canal schwanomma survivor, surgery 5/07, cyberknife 10/07 Charlotte "Ceecee" Krasinski, MBA Marketing Liason Specialist ceeceek2000@yahoo.com (941) 661-8610
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Joined: 10/10/2008
Posts: 1435
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It i being tried for people with the "failed back" syndrome, but I don't know much about the results. Knowing what to target is more difficult.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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