Botulinum Toxin Injection and Rhizotomy
Botulinum toxin A is also known as Botox, paralyzes nerves. It is primarily used to suppress the pain fibers while preserving other nerve fibers. A small quantity of the drug is injected near the roots of the upper jaw and lower jaw branches of the trigeminal nerve. Studies show that most people with trigeminal neuralgia feel significant pain relief for weeks or months after a botulinum toxin injection. Therefore, most neurologists use it as an alternative to surgery.
Studies show that rhizotomy offers pain relief to about 80% of people with trigeminal neuralgia, but it is a temporary solution that lasts one to three years, until the nerve grows back. This procedure is usually recommended for patients with multiple sclerosis-induced trigeminal neuralgia. It is not invasive and can be repeated multiple times, because the pain may come back due to the progression of multiple sclerosis [6].