A case of recurrent trigeminal neuralgia after microvascular decompression successfully treated with ultrasound-guided maxillary nerve pulsed radiofrequency

Abstract

Microvascular decompression (MVD) is the radical treatment for trigeminal neuralgia; however, some patients experience recurrence of pain after MVD. Here we report a case of recurrent trigeminal neuralgia after MVD in a young woman who was successfully treated with a postoperative maxillary nerve block by pulsed radiofrequency. The patient, a woman in her 30s, underwent MVD for paroxysmal pain in the area of the second division of the left trigeminal nerve. She experienced pain recurrence in the same area 6 months after surgery. Radiofrequency thermocoagulation performed in the left infraorbital nerve alleviated the pain temporarily; however, soon thereafter, pain in the left posterior oral region increased. Ultrasound-guided maxillary nerve pulsed radiofrequency ultimately resolved the pain. These results suggest that ultrasound-guided maxillary nerve pulsed radiofrequency is useful for the treatment of recurrent trigeminal neuralgia after MVD since it can be performed safety and is associated with few complications.