A Family Doctor's Tale - TRIGEMINAL NEURALGIA

DOC I HAVE A PAIN ON MY FACE

Trigeminal Neuralgia ( A Simple Guide to Trigeminal Neuralgia)is pain in the face due to hypersensitivity of the fifth or trigeminal nerve which supply sensation to the facial muscle and skin. 

All nerve pain can be excruciating. 

This elderly gentleman had this condition on the right side of his face for about 12 years. 
He was on constant painkillers.

The pain was so bad that he had to ask an ENT surgeon to cut off the branch of the nerve that leads to his nose and lip about 10 years ago. 
After the surgery there was no pain for 3 years though he has a bit of facial muscle droop. 
However the pain recurred after the third year of surgery. 

This time he did not want surgery because of the cost and also because the recurrence occurred even with surgery. 
There was also the side effect of a drooped facial muscle.
He was seeing instead a neurologist and his pain was relieved not totally with pain killers and a nerve pain drug called tegretol. 
However he had some gastric problem because of the strong pain killer.

Hearing about my injection for osteoarthritis and rheumatism, he came to consult me. 
I told him that the injection only worked with joint pain and not nerve pain.
In his case he needed an injection which will kill the nerve. 
In those days there were no botox injection which could kill the nerve. 
So what I used was (as recommended by an old medical book) surgical spirit. 
This was mixed with a local anesthetic and injection was done  into the nerve branch between the nose and lips. 
There was a slight droop of the face after the nerve was injected. 
Together with some painkiller, antacid and his Tegretol, the pain was reduced considerably. 

Each time there was recurrence of pain another injection was given. 

He had a total of 4 injections of the surgical spirit before the pain disappear completely.

He still comes to see me together with his wife for rheumatic pain but not for the nerve pain.

Nowadays the new aesthetic or cosmetic physician will probably inject him with botox which can cost a few thousand dollars.
Sometime an old method worked equally well. 

This is the one and only case in which I had treated with the injection of surgical spirit and successfully too.