Trigeminal Neuralgia Ronald Brisman, M.D.

# Radiofrequency Glycerol Images Trigeminal Neuralgia

 Fig 1. During Radiofrequency and/or Glycerol for trigeminal neuralgia, spinal fluid may emerge from the needle (see tip of white arrow), a favorable situation for Glycerol injection. Alternatively, the needle can be connected to a radiofrequency machine that will heat the tip of the needle and the trigeminal nerve.
 Fig 2.  At the time of the Radiofrequency procedure, the cannula (special needle) is advanced (under x-ray control) through a hole in the skull base (foramen ovale). As it is placed deeper, it moves from the third to the second division of the trigeminal nerve. The needle is insulated (pink) and the tip is uninsulated (white). Only the uninsulated part (and the adjacent nerve) is heated.
 Fig 3. This is a schematic picture of the lateral x-ray at time of the Radiofrequency and/or Glycerol procedure that shows the target for the cannula, which is the junction of the clivus and the top of the petrous bone (dashed lines).
 Fig 4. This is a schematic picture of the submentovertex x-ray at time of the Radiofrequency and/or Glycerol procedure that shows the target for the cannula, which is the hole in the base of the skull called the foramen ovale (see arrow).