The first line treatment for trigeminal neuralgia (not caused by a tumor) is medication. Studies show 88% of patients feel the pain decrease >50% after treatment.
Surgical treatment is recommended for compression-related classical trigeminal pain with good and long duration pain relief.
Non-surgical treatment, such as radiofrequency ablation, can be done for patients who have high risk for surgical complications or have non-classical (atypical) trigeminal pain.
The principle of the radiofrequency ablation (RFA) is to block the pain signals in the trigeminal nerve. The procedure is done by injecting a needle through the cheek, aiming to the trigeminal nerve with fluoroscopy (x-ray) guidance. The needle will connect to a machine that generates a high frequency current that heats and damages the trigeminal nerve. As a result, the patient will experience pain relief from severe facial pain caused by trigeminal neuralgia.
Radiofrequency ablation (RFA) has a good success rate of 91-93% to treat trigeminal neuralgia. It also has a good long-term success rate (more than 18 months of pain relief) of 81%.
Radiofrequency ablation (RFA) is considered safe with no reported mortality. But as with any other medical procedures, there are some possible complications:
- facial numbness (22%)
- painfull facial numbness (2%)
- dry eyes (1.2%)
- temporary complications: bruising from the injection, weakness of the cheek muscle, numbness of the tongue and gum
