Over a period of six months last year in Delhi, retired Professor of Biology V.P. Shobhana underwent three root canal procedures and other forms of dental treatment to rid her of the pain that tore through her face. Yet, there was no respite from it because, the problem was not dental.
It was neurological: trigeminal neuralgia that affects the fifth of the twelve cranial nerves. A branch of this nerve runs below the lower jaw. That explains why one rushes to the dentist first.
A blood vessel compression on the nerve results in searing pain, says neurosurgeon Jacob Alappat, who did a microvascular decompression surgery on Mrs. Shobhana at Aster MIMS Kozhikode to relieve her of the problem.
“I could not sleep at night. It is true that the pain can drive you to suicide. We were staying on the eighth floor of an apartment in Delhi, and I went through that urge,” she says.
Dr. Alappat wants people to learn from Mrs. Shobhana’s case how vital accurate diagnosis is to end the agony that this problem causes.
“I underwent the root canal procedures with the dentist not realising what the actual problem was. When the pain never subsided, I was referred to another dentist and after a brief course of treatment, he realised that the problem lay elsewhere,” recounts Mrs. Shobhana.
Mrs. Shobhana’s daughter got a lead on the actual problem from the doctor-husband of a contact at her workplace. At that time, the entire family was set to move back to Kozhikode.
Back in their hometown, she consulted Dr. Alappat, who identified the compression through magnetic resonance imaging (MRI). “We decided to perform a decompression surgery to provide permanent relief, though it too had the risk of five per cent to ten per cent chance of recurrence,” says the surgeon.
Surgery is the last option, after drugs prove to be ineffective. Also, those who do not want to take drugs life-long fearing side-effects, opt for the surgery. “We operate only on those who have exhausted the drug option, because a brain surgery has its share of risks too,” Dr. Alappat points out.
Accurate diagnosis is vital to end early the agony this problem inflicts on people. This is possible only if the symptoms are read clearly and patients referred to neurosurgeons.
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