Trigeminal Neuralgia – Rhizotomy

Transcript

Trigeminal neuralgia type 1 is characterized by these sharp episodes of pain on the face. One of the treatment options for this is rhizotomy, where we’re actually trying to section parts of the nerve in order to prevent those painful episodes from occurring. In this case, a rhizotomy is typically done through a needle. There are a variety of ways which can then be done to actually sever or stop those painful episodes from conducting through the nerve. What’s commonly used is a radio-frequency rhizotomy. It’s a big technical word for using heat at the tip of the needle to deaden part of the nerve and it stops the electrical impulse from conducting and the patient’s face then gets numb and people get better. There are other forms of rhizotomy as well. One is a glycerol rhizotomy where we’re actually injecting a special type of liquid to injure the nerve and stop it from conducting the electrical impulse. Yet another type of rhizotomy-like procedure is again done through a needle, except this time instead of heat or a liquid, we’re actually blowing up a balloon and applying pressure to the nerve and thereby partially stopping that conduction of the electrical impulse. Fundamentally, in the end, it’s a needle being put through the cheek all the way up through the skull base into the nerve, and then (in one fashion or another, as we’ve just described) stopping that electrical impulse from getting from the face back to the brain. For reasons that aren’t 100% clear, the pain stops, part of the face gets numb, and the patient feels much, much better and can usually stop a lot of their medications. It’s usually a temporary procedure. In some patients it’s permanent, but in most patients the pain will return a few years later.