While antiepileptic drugs such as carbamazepine, gabapentin, baclofen, or amitriptyline can be used for medical treatment, radiofrequency gangliolysis
, retrogasserian glycerol injections, microvascular decompression surgery, and the gamma knife system are other treatment modalities.
Possible surgical therapies for managing complex pain Lesional procedures Neuromodulation Other * Dorsal root entry zone * Spinal cord * Intrathecal lesioning stimulation medical therapy * Peripheral nerve * Microvascular stimulation decompression * Dorsal rhizotomy * Dorsal root ganglionectomy * Motor cortex stimulation * Rhizolysis of nerve ganglion * Cranial nerve stimulation * Neurectomy * Deep brain stimulation * Stereotactic radiosurgery * Percutaneous radiofrequency gangliolysis
* Mechanical balloon gangliolysis
* Image-guided tractotomy and nucleotomy * Cordotomy * Midline myelotomy
When medicinal treatment is no more effective various surgical modalities can be tried which include peripheral procedures like glycerol and alcohol injections, cryosurgery, peripheral neurectomy and central procedures viz microvascular decompression, radio frequency thermocoagulation, glycerol gangliolysis
, balloon compression, percutaneous retrogasserian glycerol rhizotomy and gamma knife radiosurgery10.