1. Trigeminal Neuralgia Interventional Treatment in M.S. or Balo`s disease Jalal Jalal Shokouhi-MD ISR, Tehran, Iran M.H.Herischi-MD Orthopedic surgeon,Baku,Republic Azarbayjan A.A Norosi-MD Neurosurgeon Munich,Germany A.Akbar Ameri-MD Shahid beheshti university Tehran,Iran jalaljalalshokouhi@hotmail.com

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5. Nerve blockage, if there is no organic lesion in meckle cave, cavernous sinus and parasellar, also mandibular nerve branch 3:38 AM

6. 38 cases of neuralgia 12 was known M.S 9 felame 3 male 3:38 AM

7. o CT guided o Coaxial Needle of Sieble and Grone meyer or L.P o Drugs: Lidocain 1%,Marcain0.5%, Bupivicain0.5%,Scandicain1% 3-6 cc Ethanol 65% to 90% 2-3cc Corticosteroid is controversial Mat. and meth. : 3:38 AM

8. M.S and Pain: 53 to 82% Acute: Neuropathic in acute phase Chronic: 90% Neuropathic or musculoskeletal 3:38 AM

9. Site of lesions: Trigeminal entry zone in brain stem: Tri. G. Neuralgia Brain stem, spinal cord: muscle spasm, pain full cramp Corticospinal, Corticobulbar, Spasticity, LBP, extremity pain 3:38 AM

14. R esults: All patients: pain free immediately after injection Repeat injection: No (Except in dentistry cases) 3:38 AM

15. Take home message: M.S. has diplopia, parestesia, paralysis, vertigo,... Also MS has pain. 3:38 AM

16. Thank you for your attention