Time for an update. This morning I received a call from my neurosurgeon confirming my MVD for January 24th. My other surgery will shortly follow... other surgery you say? I guess I will rewind.
I have not been back on Carbamazepine (yay!) and had just random aches here and there all year. Pretty classic prodromal sensations (so called
Pre-Trigeminal Neuralgia). I have kept out hope it was just a misdiagnosed phantom tooth ache.
During the interlude my PCP (great guy) was very patient and thought it was a good thing to continue pursuit of my dizziness, tinnitus, autophony (I can hear my eye move! and my voice and movements are really loud in my left ear). I had seen and ENT who said I simply had Eustachian Tube Dysfunction (EDT) and he said it would clear up when my allergies cleared up in a couple months but if not he would prescribe me Flonase (hint: my allergies had not been a problem for over a year since I started Flonase). My PCP and I decided that wasn't a very good diagnosis. I had been doing a lot of reading about TN and looking at my symptoms--I was kind of worried I had MS and the ear issues were just a lesion on another nerve. But my doctor really felt I had some type of comorbid issues. So I did a lot more reading (yay for people who publish medical journals online for free!) and discovered this really rare condition: Superior Canal Dehiscence Syndrome (or Superior Semi-Circular Canal Dehiscence). Some nice links
here and
here. The condition was first described as a distinct syndrome, related to a hole in the superior canal, by
Dr. Minor at John Hopkins in 1998. Thole hole creates a 3rd window in the ear which allows sound and pressure to stimulate the canal incorrectly.
My neuro thought there was a chance I had tic convuslif (compression along multiple nerves) which was causing the pulsating tinnitus but he was very gracious to hear my whacky theory and thought it wasn't a bad idea to eliminate SCDS. A week and a thin cut CT scan of my temporal bone later revealed a massive hole! My symptoms started when we were moving over the Rockies and Cascades 3 years ago (although I have always had minor symptoms) so it is likely I had a thin bone that I broke while sneezing through the passes (I had a cold and have bad allergies). The good news is we discovered the hole and it can be fixed. The bad news? Another craniotomy. Sadly when I got TN my SCDS got REALLY bad due to the Carbamazepine raising my blood pressure. This all happened in May.
My neuro was very confident I had TN and due to my health, age, symptoms, and reaction to Carbamazepine felt the MVD was the best option was the best course. I was holding out hope I didn't have TN so I agreed when the pain came back I would have the surgery.
December 2nd at about 9pm I was talking to my wife and SMACK. Right in the tongue (!) 3 sharp electrical shocks. Each was only 1 second long and were all gone within 20 seconds but man alive OUCH. It was like a cross between being kicked in the face & kissing a large car battery in a pool. The next day I had the horrible aching pain come back. I think it was being exasperated by my braces (got those in November) so I took a Motrin to take away the aching teeth and when that pain subsided the deep ache in my cheek went away. In my mind this meant I had a tooth ache... the right answer is the aching teeth were acting as a TN trigger. December 18th I had 2 more shock as I was going to bed. The first was to my left upper lip and the next was the the upper left gums. I was half asleep (until they made me jump from bed!) so it is all foggy. I really want a reason to think this could be something else... but the irretractable pain from last year that was resolved by anti-convulsants, the aches that come and then dissappear, and now the shocks are all clear enough.
We want to get this stuff behind me and the sooner the nerve can be protected from the blood vessel the better off I will be. So I made the call this week and my date is January 24th. The SCDS repair will come shortly thereafter.
I am a little nervous and have a billion things to do but in many ways I am excited to kiss 2011 and TN/SCDS good bye. I wish I never knew ya'!
Overall I am doing great. Tired often, but doing good. Spent the last year just hanging out with the kids a lot. I have been on leave from school. I am looking at recouping for 8-12 weeks from the two surgeries. And we have a new baby coming at the beginning of April. So life is good!
I hope everyone has a happy new year and stellar 2012, I know I will