The use of electrical stimulation for the treatment of trigeminal neuralgia.
The patient is positioned lying on their back, face upward with the head slightly extended. Under local lidocaine an incision is made and a specialized electrode is inserted through the cheek. Computed tomography (CT) imaging confirms positioning of the electrode at the intended target. The electrode is then connected to an external neurostimulator, and an electric current is delivered to produce a skin sensation, such as burning, prickling, itching, or tingling, in the affected area of the face. Once achieved the external neurostimulator is embedded and remains attached to the electrode. A trial stimulation period follows.
Most patients then remain in hospital for observation overnight and are discharged the following day. Instructions are provided for use of the external autostimulation device. The patient records the reduction in pain and daily drug intake using the visual analog pain rating scale. If the stimulation provides satisfactory pain relief during the trial period, then the external lead is removed and a permanent embedded connection is made to the electrode.
Risk of Trigeminal Stimulation
Infection is possible. Technical failures resulting in electrode and neurostimulator replacement are possible.