The trigeminal, or fifth cranial nerve, is responsible for sensation in the forehead, mid-face, and jaw. Irritation of the fifth cranial nerve is termed trigeminal neuralgia. Facial pain can be treated by selectively blocking portions or all parts of the trigeminal nerve. The first step in diagnosis of trigeminal neuralgia is to perform a diagnostic block, where a small amount of medicine is deposited along the path of individual nerve branches or at an intersection, where nerves sprout from the brain stem.
This delicate procedure can be safely and expertly performed using fluoroscopy, ultrasound and minimal sedation. For long-lasting relief, patients may need additional facial selective nerve blocks, and, sometimes, more long-term treatments such as neurolytic blocks with medications or Phenol, 100% Alcohol, may be necessary. Gasserian radiofrequency ablation treatments may also be considered.