Glycerol Injection for Trigeminal Neuralgia is one of the many types of treatment available.
At the beginning of the twentieth century, alcohol was injected into the Trigeminal nerve to destroy it and bring about pain relief. However, it led to several problems inlcuding blindness, and was therefore not popular. Glycerol injection was introduced in the early 1980s, and is less popular than Radiofrequency lesioning.
Does Glycerol injection destroy the trigeminal nerve?
Yes, this is also a destructive procedure like RFLG.
Because it involves injection of glycerol into the trigeminal ganglion where the three divisions meet, it can (ususally temporarily) destroy the ganglion. This is the mechanism behind pain relief after injection. Because the nerve fibres and myelin slough off after being destroyed, sensations are not carried forward into the brain, and pain relief is achieved.
How is Glycerol injected into the Trigeminal Ganglion?
like in RFLG, a needle is used to locate the trigeminal ganglion under sedation or anaesthesia and under x-ray guidance. And after certain confirmatory steps the injection is then made.
Is the trigeminal neuralgia pain relief after glycerol injection immediate?
Generally not, but usually takes a few days.
Is the pain relief permanent?
Unfortunately not. More often than not, the pain relief only lasts a few weeks to a few months.
Does the glycerol injection need to be repeated?
It could be, for achieving pain relief. This is especially so if the patient requests it.
What are the rates of success of glycerol injection for trigeminal neuralgia?
It is varied and is between 70-90%. but the effect is temporary.
What are the side effects of glycerol injection for trgeminal neuralgia?
Much like RFLG.
- Facial numbness and corneal numbness are the commonest unwanted effects of this procedure.
- Rarely a condition called anaesthesia dolorosa may develop (numbness with constant severe pain).
- Facial blisters may appear a few days after lesioning, though they are transient.
- Infection leading to meningitis may occur.
- Deaths due to internal bleeding into the brain.
What is the best treatment for TN?
MVD surgery is the best treatment, basically because it addresses the root cause. It results in the nerve no longer being compressed by the blood vessel(s). In our opinion, MVD surgery has to be considered after the initial few months of oral medication, before their unwanted side-effects take over the life of the patient.