Dry needling: A beneficial alternative for managing trigeminal neuralgia in a young patient: A case report

Trigeminal neuralgia (TN) typically affects the elderly and is uncommon in younger people. Managing a young patient resistant to pharmacological treatment could be challenging. Radiofrequency (RF) ablation of gasserian ganglion due to its side effects like deafferentation pain is a less desirable option. Dry needling reduces peripheral and central sensitization by its action on the descending pain inhibitory system and segmental antinociception. It has been successfully used to treat a variety of neuromusculoskeletal pain syndromes and could be effective in such patients. Here we present a case of a 22-year-old young man with TN of the right side of his face for 4 years, involving all the three divisions of the trigeminal nerve. He was being treated for the same with carbamazepine 200 mg thrice daily since 2 years. He suffered from paroxysms of electric shock like pain either occurring spontaneously or triggered by nonnoxious stimuli to specific areas of his face called as trigger zones. We treated him with dry needling, done in these trigger zones, which gave him more than 50% pain relief after two sessions. Hence, we conclude that dry needling could be a beneficial alternative for managing young patients with refractory TN.