TAIPEI (Taiwan News) — Tri-Service General Hospital has adopted synchronized CT and X-ray imaging technology to support trigeminal neuralgia treatment, significantly helping doctors pinpoint the location of lesions, per CNA.

The condition is a chronic nerve disorder that causes sudden, shock-like facial pain, usually on one side, and facial muscle spasms. It is typically triggered when a blood vessel presses on the trigeminal nerve. About 70–80% of cases occur in people over 40, and it is more common in women.

At a press conference on Thursday, Hsu Yung-chi (徐永吉), an anesthesiologist and director of the hospital’s pain treatment center, said about 80% of cases are caused by blood vessels pressing on the nerve, while tumors or infections may also be factors.

Treatment usually starts with anticonvulsant medication to calm the nerve. If the medicine does not work, surgery or invasive procedures may be used. Hsu noted that radiofrequency treatment can relieve pain in about 90% of cases and is suitable for seniors or those who cannot undergo anesthesia.

Hsu also explained the limitations of X-ray and CT imaging. X-ray fluoroscopy mainly shows bones and does not reveal blood vessels, so during invasive procedures, doctors must rely on experience to guide needle placement, which increases the risk of accidentally puncturing a blood vessel.

CT scans provide clearer images, but they are static and cannot show real-time needle movement or blood vessel distribution. About 15% of those with the condition develop facial swelling after receiving CT-guided invasive treatment.

To address these issues, the hospital has integrated X-ray and CT imaging with ultrasound to improve treatment accuracy. Hsu Yi-chih (許一智), director of the radiology department, said the procedure begins with placing a magnetic guide on the person’s head, followed by a CT scan of the skull base to capture images of the nerve openings. These CT images are then uploaded into the ultrasound system.

When the doctor places the ultrasound probe on the person’s face and activates the sync function, the ultrasound image aligns with the CT scan. This synchronized view allows doctors to see blood vessels, bone structures, and soft tissue in real time.

The hospital said the new technique helps prevent facial swelling or bleeding caused by inaccurate needle placement. More precise targeting of the affected area also reduces repeated punctures.