Trigeminal Neuralgia

Atypical Facial Pain


A ganglion is a bundle of interconnected nerves that are important for pain in a certain area of the body. One such ganglion is the Gasserian ganglion or trigeminal ganglion - this ganglion is important in the treatment of some types of facial pain. It is possible to relieve pain by blocking the Gasserian ganglion. The Gasserian ganglion has three nerve branches known as the trigeminal nerves. These three branches are responsible for sensation on one side of the face. A block in one part of the Gasserian ganglion is achieved by applying electrical current to the Gasserian ganglion via a needle that heats the ganglion. This stops it from passing on any more pain signs.

The treatment will be performed in a operation there. A nurse will escort you to the treatment room, where there is a treatment table, an X-ray machine and television monitors. You will be positioned on the treatment table on your back. The blood pressure and the amount of oxygen in your blood will be controlled during the treatment. A drip will be placed in your hand. The right place of the block is estimated with aid of fluoroscopy. This place is marked on the skin with a felt pen. The area around this site is then disinfected with a cold, red liquid. The pain specialist covers the area with sterile drapes. Through the drip a small amount of short-lasting anaesthetic is injected. The pain specialist under fluoroscopy (via television monitor) has placed the needle in the correct position near the Gasserian ganglion. Then small electrical currents are administrated near the Gasserian ganglion. You will feel a tingling sensation in your face. When you feel this, you must tell the treating pain specialist straight away, and not wait for it to become painful. The pain specialist will ask you where you feel the sensation and you have to point the place with your finger. By means of a special device, the pain specialist can read the distance from the needle to the ganglion. Is the needle in the right place you will be brought back to sleep again.The pain specialist will give a radiofrequency (RF) electrical current via the needle to block the Gasserian ganglion. After the treatment you have to stay at the day care centre for two hours. After this treatment you need to make an appointment at the pain clinic after six to eight weeks with your own pain specialist. The effect of treatment will be checked and further policy will discuss with you.

After pains can occur following this procedure. These may last for several weeks but will eventually disappear. The optimum results of treatment are seen after six to eight weeks.

Special Instructions

  • The treatment is done on an outpatient basis.
  • You must not eat before your treatment and take your normal medication.
  • Do not take blood thinners
  • Make sure you have someone to take you home, because you may not drive for 24 hours.

Side Effects And Complications

After Gasserian RFA procedure, the following complications or side effects can occur:

  • It is possible that small blood vessel can be hit by the needle resulting in hemorrhage of the cheek.
  • In rare cases a bacteria of the mucous membrane can enter the brain fluid resulting in meningitis.
  • If you develop a fever over 38.5 Co within 6 hours after the treatment together with headache and stiffness of the neck, you immediately have to contact the hospital or the pain clinic and your GP to be treated as soon as possible with antibiotics.
  • After this procedure numbness of a part of the face can remain for some months.