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For two weeks Natalie Cameron lay semi-conscious in Mountainside Hospital in Montclair, NJ, aware of only the severe spasms of pain shooting through her throat and neck. Diagnosed with glossopharyngeal neuralgia (GPN) in the emergency room, she was admitted and put on a variety of medications and pain killers to address the intensely painful symptoms. Her condition quickly deteriorated to the point where she refused to eat, drink, talk or even move for fear of provoking another spasm. Afraid for her life, her family began an internet search to learn more about the disease and find a neurosurgeon with the specialized training needed to treat this exceedingly rare condition.
Their quest led them to the Dr. Mark McLaughlin, director of Princeton Brain and Spine Care, one of only a handful of neurosurgeons in the world trained to surgically treat the condition. Dr. McLaughlin immediately took over Ms. Cameron’s case and moved her to University Medical Center at Princeton. After reviewing the same MRI scans that Ms. Cameron’s previous physician read as normal, Dr. McLaughlin identified a subtle abnormality with a blood vessel and confirmed the diagnosis.
A Rare but Painful Affliction
With a reported incidence of approximately 0.7 per 100,000 people per year, GPN is as rare as it is painful. The condition is characterized by brief but excruciating pain at the base of the tongue which can radiate to the ear and neck. Typical triggers include eating, drinking, sneezing, speaking, laughing or coughing.
GPN is caused by elongated blood vessels that put pressure on the nerves of the face and throat. There is a greater incidence in people over 40 simply because of the body’s natural aging process.
“Just the sheer number of heart pulsations the vessel is subjected to over a lifetime can cause it to stretch,” explains Dr. McLaughlin, adding, “As we age, the brain tends to atrophy and sag which can also cause vessels to stretch or lengthen. In Ms. Cameron’s case, a severe loop of a vessel was digging into her glossopharyngeal nerve; the nerve responsible for the sensation of the face.”
Initially, Ms. Cameron experienced isolated episodes of pain. But steadily over several months they increased in frequency and intensity to the point where she couldn’t work or perform routine activities. By the time she was admitted to the hospital her spasms were almost constant and she was incoherent from the pain.
Her physician at Mountainside Hospital recommended surgery to sever the nerve, but according to Ms. Cameron, he warned of serious side effects including possible paralysis of the tongue and loss of hearing and eyesight. Seeking a better option, Ms. Cameron’s family began searching the internet. They learned of a surgical procedure called microvascular decompression which was pioneered by Dr. Peter Jannetta at the University of Pittsburgh School of Medicine. They quickly made the leap to Dr. McLaughlin, who served his residency under Dr. Jannetta.
Once admitted to University Medical Center at Princeton, Ms. Cameron underwent a brief quiescent period to hydrate and withdraw from all unnecessary medications. During this time, Dr. McLaughlin also exhausted all conservative treatments known to alleviate the condition. Within a week, Dr. McLaughlin performed a microvascular decompression to reposition the blood vessel and eliminate pressure on the nerve.
A small hole was made in the base of the skull. An operative microscope and micro instruments were used to navigate a natural cleavage plane between the brain and skull and gain access to the brain stem and the base of the glossopharyngeal nerve. Micro instruments were then used to lift the vessel loop away from the nerve, alleviating the pressure. The vessel was then wrapped in shredded Teflon® felt to permanently maintain decompression.
“Despite the severity of the loop in the Ms. Cameron’s blood vessel, the surgery was an overwhelming success,” says Dr. McLaughlin. “Long term success rates for the procedure are high, between 70 and 80 percent, and Ms. Cameron is expected to make a full recovery.”
Ms. Cameron couldn’t be happier. “I’m pain free and my physical stamina is back. Having gone through that much pain, and knowing how it can completely destroy your life, I feel my recovery is nothing short of miraculous. Dr. McLaughlin is the true epitome of what a doctor should be. His commitment, skill and passion were evident from the start. He didn’t hesitate to take my case, even though his practice doesn’t accept my insurance. He made sure that my family and I understood the disease and explained the surgical procedure in a thorough and understanding way. He and his staff have also taken a personal interest in my recovery. I give thanks everyday that we found him.”
LastUpdate: 2018-01-28 10:48:51