Percutaneous Sonoguided Pulsed Radiofrequency Ablation for Managing Pain associated with Trigeminal Neuralgia

Abstract

Trigeminal neuralgia (TN) is a sudden, unilateral, recurrent, and intense paroxysmal pain in the region of distribution of one or more branches of the trigeminal nerve. TN can be effectively treated by minimally invasive techniques such as microvascular decompression, balloon compression, and conventional radiofrequency thermocoagulation of the Gasserian ganglion. The three divisions of the trigeminal nerve can also be individually targeted for pain relief. Pulsed radiofrequency (PRF) is an alternate technique for treating pain along specific branches and has been proven to be a minimally invasive, safe, and effective interventional treatment choice for such patients. A 36-year-old female presented with pain on the left side of the cheek and upper lip part in the infraorbital nerve distribution (V2) and was diagnosed with TN. A neurological examination and magnetic resonance imaging were done. Medical treatment was prescribed initially but showed minimal improvement. Her pain was assessed using the Numeric Pain Rating Score. PRF ablation (PRFA) was done using short bursts of radiofrequency for 2 min each cycle with silent phases in between. Adequate pain relief was achieved with no complications postprocedure.