Trigeminal neuralgia usually causes brief, severe, electric-shock-like facial pain, often triggered by light touch or everyday actions. Other dental, eye and neurological conditions can mimic facial pain. An accurate diagnosis is essential before considering a trigeminal nerve injection or radiofrequency procedure. [1]
Assessment and first treatments
Specialist assessment may include dental review, neurological examination and MRI to investigate the cause and guide treatment. Carbamazepine or oxcarbazepine are usual first-line medicines for trigeminal neuralgia, with individual checks for interactions, contraindications and adverse effects. Treatment and monitoring should be agreed with the prescriber. [1]
If pain remains disabling or medicine side effects are unacceptable, discuss procedural and neurosurgical options. These can include percutaneous treatments, microvascular decompression or stereotactic radiosurgery in suitable patients. Their benefits, recovery and risks differ. [1]
What does radiofrequency do?
Thermal radiofrequency deliberately creates a controlled lesion in selected trigeminal nerve fibres to reduce pain signals. Pain can recur, and further treatment may be needed. A temporary nerve injection and a thermal lesion are different interventions with different consequences. [2]
Pulsed radiofrequency is a different technique and should not be described as a proven equivalent that avoids every complication. Ask for the evidence relating to the precise diagnosis, target and technique being proposed.
Important risks to understand
Facial numbness is common after nerve-damaging procedures. Other possible harms include unpleasant altered sensation, chewing weakness, reduced corneal sensation and eye injury, or persistent painful numbness known as anaesthesia dolorosa. Bleeding, infection and other procedure-specific complications must also be discussed. [2]
Where the eye’s protective sensation may be affected, ask about eye protection and the symptoms that require urgent review. Do not choose a procedure on the basis of promised immediate or permanent relief.
When to seek prompt help
Severe attacks that prevent drinking or eating need prompt clinical help. New visual symptoms, a painful red eye, or new significant neurological symptoms require urgent assessment, particularly after a facial nerve procedure. [2] [3]
Questions to bring
What supports my diagnosis? Is there a treatable structural cause? How do the available options compare for pain relief, recurrence and sensory complications in my circumstances?
Related information
Sources and evidence
Evidence sources checked: 10 November 2026. This information supports a clinical discussion; diagnosis and treatment depend on an individual assessment.