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Review
. 2025 Feb;9(1):81-84.

Efficacy of Botulinum Toxin Injection via Coronoid Approach in Refractory Trigeminal Neuralgia: A Case Report and Literature Review

Mahmoud Reza Alebouyeh  1 , Saeid Reza Entezary  1 , Sajede Salehi  1 , Sara Saadat  1
Affiliations
  • PMID: 40257349
Review

Efficacy of Botulinum Toxin Injection via Coronoid Approach in Refractory Trigeminal Neuralgia: A Case Report and Literature Review

Mahmoud Reza Alebouyeh et al. Pain Med Case Rep. 2025 Feb.

Abstract

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.

Keywords: Botulinum toxin; Gasserian ganglion block; case report; coronoid approach; trigeminal neuralgia.

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Each author certifies that he or she, or a member of his or her immediate family, has no commercial association (i.e., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted manuscript.

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