Effectiveness and complication of low-dose trigeminal nerve block with alcohol in idiopathic trigeminal neuralgia

Abstract

Background: Trigeminal nerve block with alcohol was introduced long ago as a treatment method for trigeminal neuralgia. However, very little information is available in the literature regarding trigeminal nerve block with alcohol, and therefore, we evaluated the efficacy and related complications of an alcohol block of the trigeminal nerve for the treatment of indiopathic trigeminal neuralgia.Subjects and methods: Longitudinal and retrospective study in 38 idiopathic trigeminal neuralgia patients with low-dose trigeminal nerve block with alcohol from January 2019 to July 2022. Results: 38 patients were analyzed who received absolute alcohol injections in the management of trigeminal neuralgia (TN) from January 2019 to July 2022. There are 30 cases were injected with 0,3 ml of absolute alcohol and 8 cases with a greater 0,3 ml dose. The visual analogue scale (VAS) was used for pain improved with moderate level (18 cases) and severe level (12 cases) before, 24 patients had marked improvement of pain with mild level or free from pain. 30 patients (100%) who initially became free from pain experienced a recurrence of pain at least 1 year. Using the Barrow Neurologic Institude pain scale (BNI-PS), after 2 weeks there were only 2 patients (6,7%) experienced recurrent pain with BNI-PS IV, 2 patients (6,7%) with BNI-PS IV after 12 months and 5 patient (17,2%) with BNI-PS IV, 1 patient with BNI-PS V (3,4%) after more than 12 months. No serious complications were reported. Facial numbness was reported in 16 cases (53,3%) with 0,3 ml of absolute alcohol and 8 cases (87,5%) with a greater 0,3 ml dose. Other complications included: keratitis in 4 cases (13,3%) with 0,3 ml of absolute alcohol and 1 cases (25%) with a greater 0,3 ml dose, masseter muscle weakness in 7 cases (23,3,%) with 0,3 ml of absolute alcohol and 2 cases (25,5%) with a greater 0,3 ml dose.