Trigeminal Neuralgia

Trigeminal Neuralgia (Tic Doloreux) is a condition where patients experience excrutiating sharp pain in their facial areas. It usually involves one side of the face only but has been seen rarely in both sides. Many patients are over 40 and the condition is rarely seen in younger people. Its name is derived from the French where "tic" is a sudden event and "doloreux" denotes pain. There are medical treatment plans for this condition which involve trials of different types of medicines or increasing dosages. Some patients are not controlled or simply wish to treat their condition more definitely as all the medicines used have side effects varying from minor to major.

We perform the two procedures for Trigeminal Neuralgia. One procedure, Glycerol Rhizotomy, involves placing a needle into the cheek and injecting two drops of glycerol into the trigeminal nerve. This procedure is preferred for older patients in poor health. Its effects can be immediate and reoccurance sooner than 3 years is rare. For younger patients, microvascular decompression is available. Microvascular decompression involves operating through the base of the skull to move aside the vessels that press on the nerve near the brain stem and cause the syndrome.

Failed Back Syndrome

Failed back syndrome is one of the most difficult pain syndromes to treat. The typical patient that we see has already been to another surgeon, had surgery , and had little or no relief of their symptoms and in some cases, their pain is worse. Our approach has been to start with an analysis of the entire patient profile including x-rays, MRI, CT or documents regarding procedures performed on the patient. We also will ask questions of our patients that may be personal but their answers can help select patients that will respond to therapy. Patients who have pending lawsuits, whether they are against motor vehicle drivers or doctors generally make poor candidates because of their invisible desire to keep some degree of pain for disability reasons. However there are patients who are well motivated to return to work and have a positive outlook. For these folks spinal stimulators may be best especially if only one extremity is the problem. These stimulators are implanted in the spine outside the spinal cord. They are also placed in under local anesthesia to allow the doctor to interact with the patient during the stimulation.

Cancer Pain

We have experience with pump implantation for the delivery of morphine and baclofen into the spinal fluid for treatment of Spasticity as well as cancer pain. The medicine works directly on the spinal cord when delivered in this manner. Some patients experience dramatic relief.

Neurology and Neurosurgery Associates, P.A., - 50 2nd St. S.E., Winter Haven, FL 33880