Repeated Trigeminal Nerve Blocks Versus Radiofrequency Procedures for Refractory Trigeminal Neuralgia and Facial Pain: A Comparative Narrative Review
| Author | Mahmood-Reza Alebouyeh | en |
| Author | Karim Hemati | en |
| Author | Farnad Imani | en |
| Author | Ali Azizi | en |
| Author | Fatemeh Ahmadi Hafshejani | en |
| Orcid | Mahmood-Reza Alebouyeh [0000-0002-9742-0292] | en |
| Orcid | Karim Hemati [0000-0003-0893-5102] | en |
| Orcid | Farnad Imani [0000-0003-0814-0772] | en |
| Orcid | Ali Azizi [0000-0002-8315-1992] | en |
| Orcid | Fatemeh Ahmadi Hafshejani [0009-0009-2372-2472] | en |
| Issued Date | 2026-07-31 | en |
| Abstract | Context: Trigeminal neuralgia is a chronic pain disorder characterized by brief, intense, and often disabling episodes of unilateral stabbing facial pain. When medication is ineffective or causes adverse effects, treatment options include microvascular decompression, radiofrequency thermocoagulation, balloon compression, glycerol rhizotomy, Gamma Knife radiosurgery, and repeated trigeminal nerve blocks. Treatment effectiveness may decline over time, and pain may recur despite rapid initial relief. Rigorous comparative studies are scarce, and evidence on repeated nerve blocks and radiofrequency procedures often comes from small, uncontrolled studies. Evidence Acquisition: This narrative review was guided by the principles of the Scale for the Assessment of Narrative Review Articles and used structured appraisal tools, including the Newcastle-Ottawa Scale, Cochrane Risk of Bias 2 tool, AMSTAR-2, and Joanna Briggs Institute checklists, to appraise the 59 included studies. The review examined mechanisms, efficacy, duration of relief, recurrence, and complications. No study directly comparing repeated nerve blocks with radiofrequency procedures was identified; all comparisons are indirect. Results: Repeated blocks provide rapid, minimally invasive relief with a generally favorable safety profile, although their effects are often temporary. Indirect comparisons across heterogeneous study designs and populations suggest that conventional radiofrequency may provide longer-lasting relief and lower recurrence; these observations remain hypothesis-generating. Pulsed radiofrequency may preserve nerve structure and reduce sensory complications. Conclusions: Available evidence does not establish the superiority of one modality over the other. Treatment should be individualized according to patient health, preferences, and available resources. | en |
| DOI | https://doi.org/10.5812/ans-174760 | en |
| URI | https://brieflands.com/journals/ans/articles/174760 | en |
| Keyword | Trigeminal Neuralgia | en |
| Keyword | Nerve Block | en |
| Keyword | Radiofrequency Ablation | en |
| Keyword | Pulsed Radiofrequency Treatment | en |
| Keyword | Facial Pain | en |
| Publisher | Brieflands | en |
| Title | Repeated Trigeminal Nerve Blocks Versus Radiofrequency Procedures for Refractory Trigeminal Neuralgia and Facial Pain: A Comparative Narrative Review | en |
| Type | Review Article | en |
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