Outcome of Radiofrequency Rhizotomy for Treatment of Trigeminal Neuralgia

Abstract

Background: Trigeminal Neuralgia (TN) is a debilitating condition characterized by unilateral, paroxysmal pain along the trigeminal nerve. Although anticonvulsants such as Carbamazepine are first-line therapy, many patients become refractory or develop intolerable side effects. Radiofrequency rhizotomy (RFR) is a minimally invasive alternative; however, local data on its efficacy and safety are limited. This study aimed to determine the effectiveness of RFR in TGN for pain relief.
Methods: This descriptive case series study was conducted at the Department of Neurosurgery, Sir Ganga Ram Hospital, Lahore, Pakistan, between January 2025 and December 2025. The patients aged 18 to 75 years, of either gender, diagnosed with TGN involving V2 and V3, were refractory to medical treatment. Data on patient demographics (age, gender, comorbidities) and baseline clinical characteristics (disease duration, laterality, affected nerve branch, preoperative Numeric Rating Scale score) were collected before the procedure. Pain relief was assessed using the numeric rating scale at baseline, the 0th postoperative day, the 1st postoperative day, and at 4 weeks.
Results: Of the total 60 patients included, there were 40% (24) males and 60% (36) females with a mean age of 50.4 ± 11.3 years. The mean preoperative NRS pain score was 7.6 ± 0.6, which was reduced to 0.90 ± 0.65 on the first postoperative day after RFR, 0.10 ± 0.30 at 1st postoperative day, followed by almost no pain recorded at 4 weeks. All patients reported NRS≤3 at final follow-up at 4 weeks, with efficacy reported to be 100% (60), loss of corneal reflex in 5% (3), and anesthesia dolorosa in 1.7% (1) patients, and no recurrence at 1-month follow-up.
Conclusion: Radiofrequency rhizotomy is a safe and effective treatment strategy for the management of trigeminal neuralgia refractory to conservative therapy, with immediate pain relief and no recurrence at one month follow-up.