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Neurologist reveals Salman Khan's battle with Trigeminal Neuralgia, brain aneurysm, and AVM. 

About Trigeminal Neuralgia

It is a severe, chronic pain condition impacting the trigeminal nerve, which transmits sensory information from the face to the brain.

It causes severe, sudden, shock-like pain, normally on one side of the face. Even slight movements or stimuli, such as eating, brushing teeth, talking, or a light breeze, can trigger the pain.

The primary cause is compression of the trigeminal nerve by a blood vessel. Other causes include multiple sclerosis, tumors, nerve injury, or previous surgery. Women over 50 years old are more commonly affected.  

Treatment

• Medication: The first line of treatment involves medications like carbamazepine. Newer antiepileptic drugs such as oxcarbazepine and lamotrigine, as well as antidepressants like duloxetine and venlafaxine, are also used to reduce pain.
• Injections: Options include Botox injections.  
• Surgical Procedures: If medications fail, surgical options become necessary.  

Recent Advancements in Treatment

• Minimally Invasive Techniques: Newer neurolytic techniques, such as low-level laser therapy, ozone injection, pulsed radiofrequency, cryotherapy, neural prolotherapy, and fiber knife techniques, offer promising results.
• Regenerative Therapies: Platelet-Rich Plasma (PRP) therapy emerges as a non-invasive, regenerative option, utilizing a patient's own blood components to repair irritated nerve tissues and reduce inflammation.
• Non-Surgical Innovations: Transcranial magnetic stimulation (TMS) and Transcutaneous electrical nerve stimulation (TENS) are non-invasive procedures that use magnetic fields or electrical impulses to reduce pain signals.
• Improved Diagnostics: Advances in magnetic resonance imaging (MRI) techniques provide deeper insight into the pathogenesis of TN and aid in surgical planning.

About Brain Aneurysm

This condition involves a weakened area in an artery wall that expands abnormally. If it bursts, blood leaks into and around the brain, causing a subarachnoid hemorrhage (SAH).

Brain aneurysms are common; about 1 in 100 individuals may harbor an aneurysm. India reports a high annual incidence of 76,500 to 204,100 new cases of aneurysmal SAH. Roughly 40% of ruptured aneurysms in India prove fatal.

Risk Factors and Causes

• Lifestyle and Health Conditions: Uncontrolled hypertension (high blood pressure), smoking, excessive alcohol consumption, and chronic kidney disease are significant risk factors.
• Genetics and Predisposition: Heredity and a family history of aneurysms increase risk. Certain connective tissue diseases or conditions like polycystic kidney disease also play a role.
• Demographics: While they can occur at any age, brain aneurysms are most common in adults aged 30 to 60, with women, especially post-menopausal, generally at higher risk. However, some Indian studies indicate a higher incidence in men, particularly in the productive age group (35-65).

Treatment => Unruptured aneurysms may be observed, or treated with surgical clipping (closing off the aneurysm) or endovascular coiling (filling the aneurysm with coils to block blood flow). Ruptured aneurysms require immediate emergency treatment.  

About Arteriovenous Malformation (AVM)

It is a rare, congenital condition where arteries and veins in the brain connect directly without the usual network of capillaries. This abnormal connection disrupts normal blood flow and can lead to serious neurological issues.   

Symptoms => Common symptoms include headaches, seizures, neurological deficits (e.g., weakness, vision changes), or memory defects. Brain bleeding (hemorrhage) is a significant risk.

Treatment => The approach to treatment varies significantly based on the AVM's size and location.

• Surgical Removal: Conventional surgery involves directly removing the AVM.
• Endovascular Embolization: This procedure involves injecting a 'glue-like' substance to block blood flow to the AVM. It often complements surgery or radiosurgery by reducing blood flow, making other procedures safer.
• Stereotactic Radiosurgery: This technique uses highly focused radiation beams to damage the AVM's blood vessel walls, causing them to close off over time.  

Source: 

HINDUSTAN TIMES