Radiofrequency neurotomy (RFN) of the trigeminal ganglion

1. What is the indication?   

Trigeminal neuralgia.

2. What is the benefit?

Radiofrequency neurotomy is a minimally invasive needle procedure, while open brain surgery is a major operation.

3. What is radiofrequency neurotomy?

There are two types of radiofrequency neurotomy: pulsed and thermal. Pulsed radiofrequency neurotomy uses an electrical current to neuromodulate the nerves. Thermal radiofrequency neurotomy uses an electrical current to heat the nerves. This stops the sharp pain signals of trigeminal neuralgia from reaching the brain.

4. How is it performed?

• Anesthesia: You receive light sedation so you stay comfortable.
• Needle placement: The doctor guides a thin needle through your cheek to the base of your skull using X-ray guidance.
• Testing: The doctor will do sensory and/or motor testing to confirm the needle placement.
• Treatment: Pulsed or Thermal radiofrequency neurotomy

5. What are the side effects?

• In the case of thermal radiofrequency, there is a higher chance of facial numbness, muscle weakness, and temporary soreness.
• In the case of pulsed radiofrequency, side effects are very minimal and nerve function stays intact.

6. What is the recovery?

• Day procedure: You go home the same day.
• Pain relief: Relief can start immediately, though your doctor will ask you to slowly lower your medication over time.
• Duration: Pain relief can last for months or a few years. You can repeat the procedure if the pain returns.

7. How do the risks and side effects compare with surgery?

• Radiofrequency Neurotomy: Causes some degree of permanent facial numbness or tingling in the treated area. Low overall medical risk.
• Open Surgery (MVD): Carries typical risks of brain surgery, such as infection, spinal fluid leak, or hearing loss, but usually preserves normal facial feeling.

8. Where can I receive this treatment in Perth?

Dr. Ganesh performs at Perth Day Hospital (Osborne Park) and Waikiki Private Hospital (Rockingham).

Reference:

• Snel et al. Trigeminal neuralgia. Pain Pract. 2025;25: e70051.
• Ryan K, Crighton A. Trigeminal neuralgia and trigeminal neuropathic pain. Br Dent J. 2024;236(4):323-328.
• Maarbjerg S, Benoliel R. The changing face of trigeminal neuralgia—A narrative review. Headache. 2021; 61:817-837.
• Abd-Elsayed A, et al. Pulsed radiofrequency for the treatment of trigeminal neuralgia. Curr Pain Headache Rep. 2022; 26:889-894.
• Khaboushan M, et al. Comparison of stereotactic radiosurgery and rhizotomy for trigeminal neuralgia: a systematic review and meta-analysis. Neurosurg Rev. 2025;48(1):613.
• McBenedict V, et al. Outcomes of different surgical interventions for treating trigeminal neuralgia: a review. Cureus. 2024;16(8): e66724. doi:10.7759/cureus.66724.
• Irfan M, et al. Safety and efficacy of radiofrequency rhizotomy for trigeminal neuralgia in low-resource neurosurgical centres. Discover Medicine. 2025; 2:296.
• Ahmed A, et al. Short- and long-term pain relief with radiofrequency rhizotomy in multiple sclerosis patients with trigeminal neuralgia: a systematic review. Cureus. 2025;17(11): e97337. doi:10.7759/cureus.97337.