Q: I am a patient of Tri-geminal neuralgia. I was operated in UK, 8 years ago through micro vascular surgery. The pain has reappeared and until now Tegratol (Carbamazepine) tabs were relieving me of the pain, but lately I have tried Tegratol, as well as a new drug trileptal (oxcarbazepine). How can I relieve myself of this pain? And is there any way I can cure this completely?

A:None of the treatments are fool proof. While microvascular decompression has a high success rate, it may fail as well as it has happened in your case. The options open to you if the drugs are not effective are re-operation, radiofrequency lesioning or ballooning of the ganglia and glycerol injection. Each of these has its own pros and cons which you can discuss with your neurosurgeon. A dedicated MRI may identify an offending blood vessel which could help in the decision making.