Trigeminal neuralgia (TN) is a neurologic disorder, defined by paroxysmal electric shocklike painful attacks in 1 or more trigeminal nerve branches. Treatment of TN is diverse and includes minimally invasive percutaneous techniques, which consist of balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation. Although all 3 techniques are generally safe, efficient, and effective, a clear consensus has not been reached regarding their specific indications and degree of efficacy. The aim of this article is to describe the percutaneous treatments available for TN and outline their characteristics, technique, indications and efficacy.
Key points
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Minimally invasive percutaneous techniques used in the treatment of trigeminal neuralgia include balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation.
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All 3 percutaneous techniques offer a high rate of initial pain relief. However, long-term pain relief and recurrence rates vary widely among studies.
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Permanent complications are rare for each procedure. Complications may include facial hyperalgesia or dysethesias, masseter weakness, corneal analgesia, and, rarely, cranial nerve deficits.
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In certain circumstances, like multiple sclerosis-related trigeminal neuralgia or elderly patients who are not candidates for intracranial surgery, such minimally invasive procedures could be considered as a preferred treatment option.
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Intracranial Ablative Procedures for the Treatment of Chronic Pain
Microvascular Decompression for Trigeminal Neuralgia
Neurolysis, Neurectomy, and Nerve Repair/Reconstruction for Chronic Pain
Nerve Blocks for Chronic Pain
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