Mr. Chen, a man in his fifties, was diagnosed with trigeminal neuralgia more than a decade ago. The condition brought him intermittent, electric shooting or knife stabbing like facial pain. Recently, the frequency and duration of his attacks increased, severely affecting his quality of life. Two months ago, he sought help at the Pain Specialty Clinic of Taipei Medical University Shuang Ho Hospital, where a high-frequency radiofrequency ablation procedure provided significant relief from his long-standing facial pain.
If Intractable Pain Could Not Be Controlled Well with Medication—Surgery May Be an Option
Dr. Sean C.S. Lin, Director of the Pain Center at Shuang Ho Hospital and Head of Pain Management at Taipei Neuroscience Institute, explained that trigeminal neuralgia is caused by abnormal spontaneous discharges in the facial area, or induced by external stimuli that lead to hypersensitization. While most patients initially respond to anticonvulsant medications that stabilize nerve activity, 20–30% either don’t respond well or experience reduced efficacy over time. For such cases, surgical interventions become viable options.
Minimally Invasive Extracranial Interventional Procedure Lowers Risk of Complications
High-frequency radiofrequency nerve ablation, a minimally invasive technique guided by imaging, involves only a tiny needle puncture—similar to a blood draw—and no incisions. Compared to traditional craniotomy decompression surgery, this method poses lower risk and has become one of the most effective treatments for trigeminal neuralgia. The hospital also utilizes an advanced extracranial nerve branch approach, which achieves results comparable to the conventional foramen ovale entry, while significantly reducing risks of intracranial bleeding and infection.
How It Works: Inhibiting Abnormal Nerve Signals
Dr. Lin further explained that radiofrequency therapy can be divided into two main modalities. The first is low-temperature pulsed radiofrequency (under 42°C), which uses electromagnetic fields to modulate nerve activity without damaging the nerve—though it has a higher recurrence rate and less immediate pain relief compared to thermal ablation.
The second, more potent technique is high-frequency thermal ablation, which heats the nerve tissue to 60–65°C, sometimes even up to 80–90°C, to selectively burn the myelin sheath of the trigeminal nerve. This blocks the abnormal electrical discharges transmitted via saltatory conduction, effectively cutting off the pain signal.
Image 1: Dr. Sean C.S. Lin, Director of Pain Management, Taipei Neuroscience Institute
Image 2: Dr. Chiang Yung-Hsiao (left, 8th), President of Taipei Neuroscience Institute, with the medical team
Source: Health & Medical Network (健康醫療網)