What Does One Do When Trigeminal Neuralgia Comes Back?

After Various Procedures, Trigeminal Neuralgia can come back. Study discusses how they handled it.

Stereotact Funct Neurosurg. 2010 Apr 1;88(3):156-162. [Epub ahead of print]
Effect of Various Surgical Modalities in Recurrent or Persistent Trigeminal Neuralgia.
Han I, Shin D, Chang J, Kim K, Chang J, Huh R, Chung  abstract here

Unfortunately, do not have access to the whole article , but the conclusions were

Conclusion: In this study the authors demonstrate that

  • percutaneous rhizotomy is recommended for most patients with recurrent pain after MVD[microvascular decompression surgery]
  • see here for more info on rhizotomy:


  • MVD [Microvascular decompression surgery] can be effective in patients with a history of failed percutaneous procedures. Radiosurgery can be utilized to treat those that have not responded to other surgical modalities

See here for more on decompression surgery:



1) Recent poster presentation at IASP 2010 determined that most TN needed a combination of carbemazepine (Tegretol) and dilantin to capture control.

2) Recently, Botox injections have been found to give long lasting results if there is a trigger zone:
Confirmed – Botox works for Trigeminal Neuralgia – Given Into Trigger Zone

I have gotten long lasting relief injecting injecting semineurolytic to neurolytic strength local anesthetic in trigeminal nerve roots:
Alternate Approaches to Post-Herpetic Neuralgia (PHN) nike air max hombre nike air max hombre

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One Response to What Does One Do When Trigeminal Neuralgia Comes Back?

  1. Janice Cary says:

    My husband had MVD in January and was completely pain free for six months but the pain is coming back. Not getting the 200 shocks a day as before but all other pain has reared its ugly head. What could possibly be the cause after 6 months being completely pain free? We go back to our Neurosurgeon in November for a sequencing MRI and hopefully will have an answer. Could you give us a clue?
    Dear Janice,
    I am always suspicious of the neck occipital area aggravating the condition as blocks occipitally can temporarily reduce issues by 50%.
    J Headache Pain. 2012 Apr; 13(3): 199–213.
    doi: 10.1007/s10194-012-0417-x
    Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain
    T. P. Jürgens et al

    Fortunately, despite fact microvascular decompression failed, other usual measures for trigeminal neuralgia might be effective.

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