Use of Cryoneurolysis Therapy for the Management of Idiopathic Trigeminal Neuralgia

Introduction: Trigeminal neuralgia is a debilitating facial pain condition characterized by recurrent, electric shock-like episodes within the trigeminal nerve distribution. While first-line treatment involves pharmacologic therapy, treatment options are limited for patients who are refractory or poor surgical candidates. Case Presentation: We present a 75-year-old female with long-standing idiopathic trigeminal neuralgia refractory to combination anticonvulsant therapy and nerve block, with notable medication-related side effects. Management and Outcomes: The patient underwent percutaneous cryoneurolysis targeting the maxillary (V2) and mandibular (V3) divisions of the trigeminal nerve under fluoroscopic guidance. She experienced immediate pain reduction and complete symptom resolution at a one-month follow-up with no complications. Conclusion: This case highlights percutaneous cryoneurolysis as a minimally invasive treatment option for selected patients with refractory trigeminal neuralgia who are not candidates for open surgical intervention.