DEAR DR. DONOHUE: My mother was diagnosed with trigeminal neuralgia several years ago. When the symptoms occur, she is in extreme pain. What are some treatment options? How about acupuncture or Chinese herbs? She has taken medicines, but they make her lightheaded and sleepy. She is resistant to taking any kind of medicine. — N.G.

ANSWER: The trigeminal nerve sends facial sensations to the brain. Trigeminal neuralgia, also called tic douloureux, is a malfunction of that nerve that causes horrific attacks of facial pain. The attacks last from a few seconds to 10 minutes, and occur daily, every few days or at longer intervals. People suffering from this malady, however, are always on the edge of their seats, waiting for the next jolt of pain. A gentle breeze on the cheek, washing the face, shaving, brushing the teeth, eating, talking and hundreds of other innocuous stimuli can trigger paroxysms of pain. I don’t know if your mother has tried all the medicines. How about Tegretol (carbamazepine), Lioresal (baclofen), and Neurontin (gabapentin)? I don’t believe acupuncture or herbs will help. A surgical approach has been a godsend for patients. It’s microvascular decompression. In most sufferers, the cause of pain is a pulsating artery that encircles the trigeminal nerve. The artery’s pulsations stimulate the painful attacks. A neurosurgeon can place spongelike material between the artery and nerve to stop the stimulation. It’s a very successful operation. Or the nerve can be treated with targeted radiation. The gamma knife is an example. People go home right after the treatment.

The nerve also can be put out of commission with injections of alcohol or glycerol, or be compressed with a balloon. Your mom needs to contact the Facial Pain Association, formerly the Trigeminal Neuralgia Association, for more information and support. The association’s Web site is: www.fpa-support.org.

DEAR DR. DONOHUE: My daughter frequently gets water on her knees and has to have them drained. Is there any way to keep this from happening? — C.V.

ANSWER: I have to know what her diagnosis is. Water on the knee can be housemaid’s knee, a knee bursa swollen with fluid. People who are on their knees a lot irritate the bursa, and it fills with fluid. Rest, protective padding and nonsteroidal anti-inflammatory drugs (Aleve, Advil) often can end the problem. In resistant cases, the bursa is removed.

Or she could have arthritic knees. In that case, arthritis treatment has to be instituted. Again, medicines such as the anti-inflammatory drugs can be a big help.

How about writing back and giving me her diagnosis?

DEAR DR. DONOHUE: After tests for an unrelated problem, it was discovered that my daughter, 11 years old, has only one kidney. She has no kidney problems — no signs or symptoms. What are her chances of living normally? — C.T.

ANSWER: Nature has been bountiful to us in giving us two kidneys. We do well with one. In fact, we do well even with just part of one. Your daughter’s lifespan and health should be no different from that of a person with two kidneys.

TO READERS: Questions on urinary tract infections are seen on a daily basis. The booklet on this topic explains them and their treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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