Percutaneous Trigeminal Ganglion Stimulation as a Treatment Modality for Anesthesia Dolorosa: A Case Report.

BACKGROUND AND IMPORTANCE: Anesthesia dolorosa (AD) is a rare, debilitating type of deafferentation pain, with an incidence between 0.3% and 2%, typically resulting from iatrogenic injury to the trigeminal nerve, such as after trigeminal rhizotomy. As a chronic and debilitating pain disorder that is often refractory to pharmacological treatments, different approaches are needed to improve treatment outcomes. As neuromodulation techniques evolve, direct stimulation of the trigeminal ganglion has emerged as a potential therapeutic option for this debilitating condition. CLINICAL PRESENTATION: We report a 71-year-old woman with trigeminal neuralgia secondary to multiple sclerosis who developed severe, medically refractory AD after multiple rhizotomies. After the placement of a trigeminal ganglion stimulator, she achieved substantial pain relief that enabled improved quality of life and daily functioning. CONCLUSION: This case highlights the potential of trigeminal ganglion stimulation as a promising treatment modality for AD, even in the context of severe peripheral deafferentation. Given the patient's marked improvement, this technique warrants further investigation as a viable option for managing refractory cases of AD.