For some patients, the mechanism of facial pain extends beyond the trigeminal nerve itself and originates in the deep structures of the brain.
In very select patients, deep brain stimulation may be considered as a treatment option for refractory facial pain. This procedure involves insertion of electrodes into the face and pain centers of the brain, connected to a generated (similar to a pacemaker) to modulate these structures.
This procedure is performed by Dr. Jean-Phillipe Langevin, using a frameless technique in the operating room. Given the extreme conditions at which this procedure is considered, results are quite limited.
Side effects include infection, bleeding, wound breakdown, generator failure and misplaced leads.