Trigeminal neuropathy is defined as facial pain in the distribution(s) of one or more branch(es) of the trigeminal nerve, caused by another disorder and indicative of neural damage. The pain is usually continuous and is described as burning or squeezing. Itching sensations are also common. This condition is difficult to treat with the current pharmacologic armamentarium, and destructive procedures such as, for example, radiofrequency rhizolysis or balloon compression are contraindicated because they most often aggravate the pain. Shelden et al may have been the first to describe trigeminal neurostimulation, albeit of the distal branches and not the Gasserian ganglion (GG) itself. Others have since successfully treated patients with neurostimulation of the supraorbital nerve (V1) and infraorbital (V2) divisions for trigeminal pain, but stimulation of the mandibular division (lingual nerve) is deemed difficult.
1Percutaneous GG neuromodulation is a treatment option for trigeminal neuropathy that has been supported by the literature since its introduction by Steude et al, and should be considered before more invasive techniques like deep brain stimulation or motor cortex stimulation.
- Talbot C.E.
- Zhao K.
- Ward M.
- Kandinov A.
- Mammis A.
- Paskhover B.
Neuromodulation of the lingual nerve: a novel technique.
J Neurosurg. 2020; 134: 1271-1275
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- Neuromodulation of the lingual nerve: a novel technique.J Neurosurg. 2020; 134: 1271-1275
- Placement and anchoring of trigeminal neurostimulation electrodes: technical report.Stereotact Funct Neurosurg. 2019; 97: 285-292
- Percutaneous trigeminal stimulation for intractable facial pain: a case series.Neurosurgery. 2020; 87: 547-554
- Stimulation of the Gasserian ganglion in the treatment of refractory trigeminal neuropathy.J Craniomaxillofac Surg. 2017; 45: 39-46
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Published online: April 21, 2023
Accepted: March 13, 2023
Received in revised form: February 19, 2023
Received: December 28, 2022
Publication stageIn Press Corrected Proof
Conflict of Interest: The authors reported no conflict of interest.
Source(s) of financial support: The authors reported no funding sources.
© 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.