This procedure is done under local anesthesia and sedation. After the patient is put to sleep the surgeon inserts the needle starting at the corner of the mouth and going to the base of skull.
Once the needle is in place the curved electrode is advanced through it. By rotating the curved tip and advancing the electrode the surgeon locates the specific division of the trigeminal nerve causing the pain.
At this point the patient is awakened. A small current is applied and slowly increased until the patient’s pain is reproduced at a small level similar or less severe then that associated with the neuralgia. The patient is asked to describe the area where the sensation is felt and if this is similar in location and description to the pain that they have suffered in the past.
When the correct division is located the patient is put back to sleep and the radiofrequency current is used to heat the nerve and block the transmission of pain. After the production of the lesion its effectiveness is tested the patient is again awakened to determine if the lesion has disrupted the pain.
Areas of the patient’s face are tested for sensitivity by pinprick. The desired goal is a sensation of marked reduced sharpness to principle but preservation of touch and feeling in the face. The surgeon lightly touches the patients face to ensure that normal touch is not painful.
Doctor does the test for normal jaw strength and mobility by having the patient open and closes their mouth and clenches their teeth. Eye movements are determined to be normal with no double vision present. This is an outpatient procedure. Pain relief is immediate and numbness of the face may be a side effect.
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