Mark E. Linskey, M.D.
Department of Neurological Surgery
University of California, Irvine Medical Center
101 The City Drive, Bldg. 56, Suite 400
Orange, CA 92868
714-456-6966
http://neurosurgery.uci.edu/facultybio/linskey/
Transcript: Kids & TRIGEMINAL NEURALGIA
Trigeminal neuralgia can occur in children but it’s much rarer. The children are not just young adults. They have very special needs and they’re very special specific circumstances that have to be taken into account.
Number one, if the child is young enough that they’re below the age of speech, you may not know what’s going on. They may suddenly be screaming with no apparent cause. This can be very, very troublesome to parents who understand that their child is in severe pain and that something is wrong but they can’t tell them what it is. Even if they are above the age of speech but below the age of reasoning, it can be very hard for them to explain what’s going on, particularly if they’ve always had this since before acquiring speech.
Other special things to consider are that the medicines that we use for trigeminal neuralgia are general electrical suppressant medicines that are anti-seizure medicines. These medicines are experienced with epilepsy and children with epilepsy clearly have affects on the developing brain in terms of development, in terms of intelligence, and long-term exposure to these medicines are something to be considered very carefully.
Finally, if you are going to undergo a procedure, perhaps a surgical procedure, to try and relieve the problem, you now need a procedure that has a much longer period of effect. You’re not talking about obtaining relief for five to ten years and then maybe needing to repeat it once before your natural lifespan runs out. You’re looking at seventy to eighty years of potential exposure and so we tend to favor a more long-term solution such as microvascular decompression earlier.
Here you also need to take into account that with children, the vascular lesions we find at the trigeminal nerve can be more complex than in adults. Its part of the reason for having obtained or having the disease develop this young is that there’s often an usual circumstance there so it becomes even more important to have the surgeon involved be somebody who’s extremely experienced and is doing a regular high volume of these cases.