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What is trigeminal nerve radiofrequency?

Radiofrequency is a minimally invasive procedure used to neutralize the pain signals produced by the trigeminal nerve, through the use of high frequency electromagnetic waves. This will reduce the pain significantly, although not permanently. 

What cases is it used for?

It is used mostly to treat trigeminal neuralgia when pharmacological treatment has not provided pain relief. Trigeminal neuralgia is a chronic pathology, which consists of intense and episodic pain that affects one of the trigeminal branches: ophthalmic, maxillary or mandibular.

It affects more women than men, and more often after the age of 50. This facial pain occurs suddenly and episodically, and is usually triggered by tactile stimuli on the surface of the face or other activities such as chewing, talking, yawning or brushing your teeth.

With magnetic resonance imaging of the brain, we see that the main cause of this pathology is neurovascular compression. The most frequent culprit is the superior cerebellar artery (90%), followed by the anteroinferior cerebellar artery (10%), which cause mechanical irritation on the nerve.

However, there are other causes for this pathology that do not improve with microvascular decompression: chemical irritation, HIV, multiple sclerosis, herpes zoster infection, among others. So, in these cases, the treatment chosen is usually radiofrequency to the trigeminal nerve.

What does this procedure involve?

It is a radiologically guided percutaneous surgical procedure, which can be performed under general anesthesia or only light sedation.

To carry it out, an active point needle is inserted from the side of the mouth, through the inside of the cheek, to enter the cranial cavity through the foramen ovale (the exit hole of the 3rd branch of the trigeminal nerve). Once in place, thermocoagulation of the affected nerve branch is performed at 65-70ºC for 60-90 seconds, up to 3 times.

Recovery and rehabilitation

Trigeminal nerve radiofrequency can be performed on an outpatient basis, so the patient can go home the same day, although in some cases it may require a short hospital stay of one night. The most common situation is that the patient can return to normal life the same day or, at most, the next day.

Risks of the procedure

As this is an uncomplicated procedure, risks are usually rare. However, here are some surgical risks or side effects that may occur: 

  • Hematomas in the check or intracranial hemorrhage, very rarely.
  • Paralysis of the face or other cranial nerves, very rarely.
  • Paralysis of the corneal reflex, rare.
  • Anesthesia dolorosa, very rarely, or hypoesthesia (facial numbness) of the affected area, infrequently.

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