Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia

Abstract

The aim of this prospective, randomized, double-blinded study was to evaluate the effect of pulsed radiofrequency (PRF) in comparison with conventional radiofrequency (CRF) in the treatment of idiopathic trigeminal neuralgia. A total of 40 patients with idiopathic trigeminal neuralgia were included. The 20 patients in each group were randomly assigned to one of the two treatment groups. Each patient in the Group 1 was treated with CRF, whereas each patient in the Group 2 was treated by PRF. Evaluation parameters were: pain intensity using a Visual Analogue Scale (VAS), patient satisfaction using a Patient Satisfaction Scale (PSS), additional pharmacological treatment, side effects, and complications related to the technique. The VAS scores decreased significantly (p<0.001) and PSS improved significantly after the procedure in Group 1. The VAS score decreased in only 2 of 20 patients from the PRF group (Group 2) and pain recurrence occurred 3 months after the procedure. At the end of 3 months, we decided to perform CRF in Group 2, because all patients in this group still had intractable pain. After the CRF treatment, the median VAS score decreased (p<0.001) and PSS improved (p<0.001) significantly. In conclusion, the results of our study demonstrate that unlike CRF, PRF is not an effective method of pain treatment for idiopathic trigeminal neuralgia.

Pulsed Radiofrequency Treatment for Trigeminal Neuralgia

“…Such a meticulous process, however, was not described for PRF. It appears that they performed a PRF treatment procedure, wherein 2 bursts of 20 ms were applied for 120 s at an output of 45 V (15). Notwithstanding the different end-points of both treatments, we feel that an unfair comparison had been made with regard to 2 aspects: 1) Similar to RF, if more than 1 branch of the trigeminal nerve is affected, PRF application to other affected trigeminal distributions is equally important.…”

“…This technique had been performed for various other conditions and has been shown to be effective and safe. There are contrasting opinions regarding the use of PRF treatment for TN, (14,15) but in our opinion, one of the main reasons for this discrepancy is the insufficient PRF dose used in most studies.…”

Two Needle Electrode System for Trigeminal Neuralgia Radiofrequency of Gasserian Ganglion

“…We used a temperature of 65°C for all the patients being well tolerated and safe. It's wellknown that serious complications often occur at a temperature ≥70°C [16][17][18]. Our opinion is that the optimal temperature should be between 60 and 65°C.…”

Trigeminal Neuralgia—A Debilitating Facial Pain

“…However, current evidence suggests the pain relief outcome following pulsed RFT is inferior when compared to traditional RFT. 40 There is only limited evidence to support the use of these percutaneous techniques. The chief outcome measures are relating to pain relief, with no RCTs and only scant evidence from prospective case series.…”