Percutaneous Radiofrequency Rhizotomy for Prompt Pain Management in Peculiar Cases of Trigeminal Neuralgia

Background: Trigeminal neuralgia is a neurological condition characterized by episodes of intense stabbing or electric shock-like pain caused by disorder of the fifth cranial nerve. Most TN cases are caused by vascular compression, but rarely it can be caused by tumor or autoimmune diseases (e.g. multiple sclerosis). Case presentation: We report two rare cases of secondary trigeminal neuralgia caused by tumors. The 1 st patient is a 38 year old male with intractable pain and MRI result suggestive of trigeminal schwannoma at the left cerebellopontine region, while the 2 nd patient is a pregnant 26 year old female with MRI result suggestive of an epidermoid cyst at left cerebellopontine region compressing the trigeminal and and facial nerve. Surgical option was declined by both patients because of the associated risks although immediate pain relief was needed. Percutaneous radiofrequency rhizotomy (PRFR) was chosen for prompt pain management and results showed immediate pain relief. Conclusion: We conclude that PRFR is an effective option for pain management in secondary trigeminal neuralgia patient in whom primary treatment for the underlying cause is not feasible.