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Updated: Jul 17, 2026
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Fluoroscopy-Guided Radiofrequency Ablation of the Supraorbital Nerve for Refractory Painful Post Herpetic Trigeminal
Jessica Hanflink1, Vida Motamedi2, Tigran Kesayan2,3
1Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL.
Background:
Post-herpetic Neuralgia (PHN) is the most common complication of Herpes Zoster (HZ) and is characteristically difficult to treat with limited pharmacologic and interventional options. We present a case of PHN of the supraorbital branch of the trigeminal nerve successfully treated with thermal radiofrequency ablation.
Case Report:
An 82 year-old woman with a 7 year history of supraorbital branch neuralgia following HZ, presented to clinic with pain refractory to a multimodal oral pain regimen. Her pain resolved for 3 days after a supraorbital nerve block, and she had durable relief following right supraorbital thermal radiofrequency nerve ablation (RFA) which produced a > 75% decrease in her pain and lasting for months. She currently continues to receive this treatment every 6 to 10 months.
Conclusion:
When medications fail, RFA is a potential treatment option for V1. Additionally, the risk of post-RFA neuritis and anesthesia dolorosa should be considered.