Is peripheral alcohol injection of value in the treatment of trigeminal neuralgia? An analysis of 100 cases

This retrospective study assessed the effectiveness and complications of peripheral alcohol injections in the management of trigeminal neuralgia (TN). 100 patients were analyzed who received 250 peripheral alcohol injections from June 2004 to January 2010. The duration of effect of alcohol blocks, the effect of repeated administration, and complications associated with alcohol injections were examined. The distal injection technique was applied. The branch of the nerve was identified and confirmed. After carefully anesthetizing the nerve with local anesthesia, 1-1.5 ml of absolute alcohol was injected depending on the nerve involved. Pain relief lasted for a mean of 14.13 +/- 8.66 months. There was a fall in the duration of effect with subsequent injections. No serious complications were reported. Only 3% patients presented with non-neuralgic pain, swelling, burning sensation, trismus, dysesthesia, soreness, infection and the expected loss of sensation along the branch involved in TN. The combination of efficacy and reduced morbidity makes this procedure preferable for the treatment of TN. Alcohol injections are useful in those who are refractory to drug therapy, the elderly, medically compromised patients, unwilling to undergo neurosurgical procedures and in whom surgery is delayed for any reason.