Trigeminal Nerve Block

mage-guided anesthetic and neurolytic block of the trigeminal nerve and its branches for trigeminal neuralgia, facial pain syndromes, and refractory headache — performed by Tzvi Grossman, MD.

Precision Block for the Most Intense Facial Pain

Trigeminal neuralgia — often described as the most painful condition known in medicine — is caused by abnormal activation of the trigeminal nerve (cranial nerve V), producing electric shock-like facial pain triggered by ordinary activities such as eating, speaking, or touching the face. When medication alone is insufficient, image-guided trigeminal nerve blocks offer targeted relief by interrupting nerve transmission at the branch or ganglion level.

Dr. Grossman performs trigeminal nerve blocks with fluoroscopic and/or ultrasound guidance, accessing the nerve at peripheral branch levels (supraorbital, infraorbital, mental foramina) or at the Gasserian ganglion via the foramen ovale approach for more proximal, durable effects.

Conditions Treated

• Trigeminal neuralgia (classic and atypical)
• Post-herpetic neuralgia of the face
• Trigeminal autonomic cephalalgias
• Neuropathic facial pain after dental procedures
• Hemifacial pain syndromes
• Refractory headache with facial component

Block Targets

• V1 (Ophthalmic): Supraorbital / supratrochlear foramen block
• V2 (Maxillary): Infraorbital foramen or pterygopalatine fossa
• V3 (Mandibular): Mental foramen or foramen ovale
• Gasserian Ganglion: Foramen ovale approach under fluoroscopy — broadest coverage