| Summary: | Trigeminal neuralgia (TN) is one of the most excruciating variety of craniofacial neuralgias with 12% prevalence in general population. It can be either primary (idiopathic, 90% cases) or secondary (due to pathology such as tumor, multiple sclerosis [MS], and arteriovenous malformation, 10% of cases). TN has a 20 times higher risk of prevalence in patients with MS with an average incidence of 2%. Bilateral TN is significantly more common in patients with MS (18%) when compared to the normal population (5%). Pharmacotherapy is the first line and mainstay of management, but a small percentage of patients continue to have unremitting pain requiring other management modalities such as minimally invasive percutaneous techniques, microvascular decompression, or stereotactic radiosurgery. There is, however, no consensus at present regarding its selection for an individual patient. This case report highlights successful application of radio-frequency ablation in a patient with MS who had bilateral presentation with different timings.
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