Peripheral Nerve Blocks as Emerging Treatment for Trigeminal Neuralgia

What are peripheral nerve blocks?

Nerve blocks are medical procedures that block specific nerves from sending pain impulses to the central nervous system (CNS). They are categorized in several ways: why they are done (therapeutic, diagnostic, prognostic or preemptive), how they are done (non-surgical or surgical), and where they are done on the body (neck, back, shoulder, face, etc.).

Peripheral nerve blocks involve injecting medication around a target nerve or bundle of nerves that are causing pain. This can block sensations of pain from a targeted area. They are a form of regional anesthetic, which usually last longer than local anesthesia.

What is trigeminal neuralgia?

Trigeminal neuralgia is a neuropathic pain condition which develops when damage occurs to a trigeminal nerve. The trigeminal nerves are the main nerves on each side of the face — each side of the face contains one trigeminal nerve. They are responsible for carrying the sensations of pain and touch to the brain from areas of the face including, but not limited to, the mouth, nose and cheeks. When trigeminal neuralgia occurs, even a mild sensation (washing the face, eating a snack or a slight breeze touching the face, etc.) can cause intense pain. Individuals with trigeminal neuralgia often describe the pain as electric shock sensations. The condition is chronic, and the intensity and frequency of pain typically increase over time.

Peripheral nerve blocks as emerging treatment for trigeminal neuralgia

Although the efficacy in short-term and long-term management of trigeminal neuralgia with peripheral nerve blocks has not been studied in depth, it is emerging as a new treatment option. During this procedure, a numbing medication is injected where the trigeminal nerve reaches the face. The goal is to calm the hyperactive nerve branch that is sending pain signals to the brain. By injecting anesthesia into the trigeminal nerve site, the transmission of painful nerve pulses is interrupted; therefore, eliminating or reducing trigeminal neuralgia-related pain.

Studies

Small studies of individuals with trigeminal neuralgia revealed that each participant experienced some degree of relief following the peripheral nerve blocks. Relief of symptoms ranged from short-term to several months. Studies conclude that it may be a safe alternative to opioids, radiofrequency thermal lesioning, or surgical procedures.

Conclusion

While larger studies and additional research is needed, the results of pilot studies appear to indicate that peripheral nerve blocks could be a viable consideration for those with trigeminal neuralgia. This is especially true for those who are older in age, had no pain relief with other treatment methods, or are looking for a low-risk treatment option.

Additional source: Chobanian & Avedisian School of Medicine: Boston University