Cervical Spinal Dorsal Root Stimulation in Trigeminal Neuralgia

Abstract

BACKGROUND: The treatment of trigeminal neuralgia is a challenge especially for cases refractory to the common standard of care. Neurostimulation for pain relief has been used over the years with different targets and modalities. Few reports exist about the stimulation of high cervical spinal dorsal roots to treat trigeminal pain. CASE REPORT: We report a case of a refractory secondary trigeminal neuralgia that was progressively resistant to various treatments. A trial for upper cervical spinal dorsal root stimulation provided immediate good facial pain relief, evoking paresthesias only in the cervical dermatomes. Positive results were obtained over 3 years with reduction of pain, drugs, and improvement in quality of life. DISCUSSION: Neurostimulation of the high cervical spinal dorsal roots with the activation of the trigeminocervical complex may be an effective and safe treatment for refractory trigeminal neuralgia. KEY WORDS: Spinal dorsal root neurostimulation, trigeminal neuralgia, trigeminocervical complex