Cryotherapy in the management of paroxysmal trigeminal neuralgia

Abstract

Paroxysmal trigeminal neuralgia still remains a difficult condition to treat. Carbamazepine (Tegretol) has been a first line treatment, failing this surgery becomes necessary. However, many surgical procedures result in permanent sensory loss. Peripheral cryotherapy, along with the recently described Jannetta (1976) and Hakanson (1981) techniques, attempt to preserve sensation. Cryotherapy to 53 branches of the trigeminal nerve in 39 patients, who were followed up for 4 years, resulted in pain relief out-lasting return of sensation. These cases show that cryotherapy applied to the correctly located affected nerve branches can produce results which are unobtainable by other methods of pain control in paroxysmal trigeminal neuralgia.