A trigeminal nerve block is an injection of medicine used to relieve facial pain. The trigeminal nerves supply the face, help with chewing, biting, and swallowing, and are responsible for sensing pain.
What conditions are treated with the trigeminal nerve block?
A trigeminal nerve block is used to treat:
- Trigeminal neuralgia
- Atypical facial pain syndromes
- Herpes zoster infection (shingles)
What is trigeminal neuralgia?
Trigeminal neuralgia (TN) is a rare condition that affects less than 200,000 people in the United States. Often called tic doloureux or prosopalgia, TN presumably is caused by a blood vessel that presses on the trigeminal nerve as it leaves the brainstem. This condition is thought to affect older people more because as a person ages, blood vessels elongate and press on a branch of the trigeminal nerve. In addition, people with multiple sclerosis are at higher risk, because the disease causes deterioration of the nerve covering (myelin).
How do I prepare for the procedure?
When you arrive at the surgical center, a nurse will go over the benefits and risks of the trigeminal nerve block and ask you to sign a consent form. After you change into a gown, the nurse puts an IV catheter in your arm to administer necessary fluids and medications.
How is a trigeminal nerve block done?
After you are positioned on your back on the procedure table, a sedative is given to help you relax. The skin on the side of your face is cleaned with an antiseptic, and the doctor injects a local anesthetic into the skin to numb the area. Using real-time x-ray guidance, the doctor inserts the procedure needle near the trigeminal nerve and instills a local anesthetic and corticosteroid agent.
How long does the trigeminal nerve block take?
The procedure only takes around 20 minutes, but expect to be at the medical facility for about an hour. You are allowed to go home after the procedure but should arrange to have someone drive you.
How effective is the trigeminal nerve block?
Many patients report immediate relief following the injection. However, some patients report return of pain after the anesthetic wears away. Full effectiveness of the block is not felt for 2-3 days, after the steroid begins to work. Pain relief duration varies from person to person. Many patients report 4-8 weeks of pain relief. For some people, more than one injection is necessary. It is not uncommon for a patient to have 3-5 nerve blocks.
What risks are associated with the trigeminal nerve block?
There are a few risks to consider with the trigeminal nerve block. While rare, these include swelling, soreness, bruising, infection, nerve damage, and bleeding.
What side effects could occur?
Most patients report numbness of the face for several minutes after the injection. Additional side effects include problems swallowing and difficulty chewing. These side effects are short-term and usually, subside after 2-3 hours.
What can I expect after the procedure?
After the trigeminal nerve block, you cannot drive or engage in rigorous activities for 24 hours. We recommend that you gradually return to activities as tolerated, and can go to work the next day.
What is the success rate of the trigeminal nerve block?
According to a recent clinical study, 100% of study participants reported pain relief with the trigeminal nerve block. Of these patients, 80% had immediate pain relief.
Resources
Nader A, Kendall MC, De Oliveria GS, et al. (2013). Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain. Pain Physician, 16(5), 537-545.
