Mark V Koning1, Nick J Koning2,3, Henk M Koning4, Maarten van Kleef5,6. 1. Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands. 2. Departments of Anesthesiology and Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Integrated Neurovascular Biology, INSERM U1083, CNRS UMR 6214, LUNAM University, Université d'Angers, Angers, France. 4. Department of Pain Therapy, Medical Center Jan van Goyen, Amsterdam, The Netherlands. 5. Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, The Netherlands. 6. Department of Anesthesiology and Pain Management, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
INTRODUCTION: The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) treatment of the trigeminal ganglion for treating patients with trigeminal neuralgia, to determine which patients have a long-term benefit, and to evaluate the effect of RF parameters. METHODS: A retrospective study in 28 consecutive patients in combination with a follow-up questionnaire (n = 26, 93% response). RESULTS: An initial treatment effect of 89% was observed, 60% sustained at 12-month follow-up. Major side effects were hypesthesia (56%), dry eye (20%), and masseter muscle weakness (12%). A lower sensory stimulation threshold during treatment was associated with better patient satisfaction (P = 0.016), improved pain relief (P = 0.039), and trended toward more hypesthesia (P = 0.077). DISCUSSION: This low-volume study reported treatment effects in an older population that were similar to previous studies. Only a higher incidence of hypesthesia was detected by long-term follow-up. This study supported the high efficiency of RF treatment, but there was a high level of side effects. Most notable, low sensory stimulation was associated with increased hypesthesia, whereas higher stimulation levels yielded less effectiveness. Further investigation of an optimal sensory stimulation range for percutaneous RF treatment of the trigeminal ganglion was found to be warranted.
INTRODUCTION: The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) treatment of the trigeminal ganglion for treating patients with trigeminal neuralgia, to determine which patients have a long-term benefit, and to evaluate the effect of RF parameters. METHODS: A retrospective study in 28 consecutive patients in combination with a follow-up questionnaire (n = 26, 93% response). RESULTS: An initial treatment effect of 89% was observed, 60% sustained at 12-month follow-up. Major side effects were hypesthesia (56%), dry eye (20%), and masseter muscle weakness (12%). A lower sensory stimulation threshold during treatment was associated with better patient satisfaction (P = 0.016), improved pain relief (P = 0.039), and trended toward more hypesthesia (P = 0.077). DISCUSSION: This low-volume study reported treatment effects in an older population that were similar to previous studies. Only a higher incidence of hypesthesia was detected by long-term follow-up. This study supported the high efficiency of RF treatment, but there was a high level of side effects. Most notable, low sensory stimulation was associated with increased hypesthesia, whereas higher stimulation levels yielded less effectiveness. Further investigation of an optimal sensory stimulation range for percutaneous RF treatment of the trigeminal ganglion was found to be warranted.
Authors: Young Suk Kwon; So Young Lim; Jong Ho Kim; Ji Su Jang; Chul Ho Kim; Kwang Jun Kwon; Jun Heum Yon Journal: Pain Res Manag Date: 2015-09-10 Impact factor: 3.037