Efficacy of Botulinum Toxin Injection via Coronoid Approach in Refractory Trigeminal Neuralgia: A Case Report and Literature Review.

[BACKGROUND] Trigeminal neuralgia (TN) is a well-characterized form of cranial neuralgia that affects one or more divisions of the trigeminal nerve. The first-line treatment for TN is pharmacotherapy, though over 40% of patients may become refractory to medication or experience intolerable side effects. A Gasserian ganglion block is a minimally invasive procedure aimed at alleviating TN symptoms and reducing the reliance on pharmacotherapy.

[CASE REPORT] We present a case of TN that was refractory to 2 times Gasserian ganglion block. While botulinum toxin has been effectively used in various nerve blocks, we opted to manage the patient's TN by targeting the peripheral mandibular nerve (V3) via a coronoid approach by using botulinum toxin injection.

[CONCLUSIONS] Our patient experienced 5 months' considerable pain relief, which demonstrates that the V3 injection of botulinum toxin may offer a viable alternative for managing refractory TN.