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Abstract

1. 2025;9;81-84 Efficacy of Botulinum Toxin Injection via Coronoid Approach in Refractory Trigeminal Neuralgia: A Case Report and Literature Review
   Case Report
   Mahmoud Reza Alebouyeh, MD, Saeid Reza Entezary, MD, Sajede Salehi, MD, and Sara Saadat, MD.

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.

KEY WORDS: Botulinum toxin, case report, coronoid approach, Gasserian ganglion block, trigeminal neuralgia

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