Efficacy and Safety of Repeated Percutaneous Radiofrequency Thermocoagulation for Recurrent Trigeminal Neuralgia

Abstract

Background: Percutaneous radiofrequency thermocoagulation (PRT) is used to treat trigeminal neuralgia (TN) with a satisfactory pain relief but a high recurrence rate.Objective: To explore the efficacy and safety of repeated PRT for recurrent TN as compared to patients who received the first PRT.Methods: Between January 2013 to May 2013, 31 patients with recurrent TN who have been treated with PRT previously were recruited and underwent repeated PRT (group A), and compared with 41 TN patients received the first initial PRT (group B). Visual Analog Scale (VAS) score was assessed preoperatively and postoperatively after 2 years of follow-up, and compared in terms of initial pain relief, complications, and recurrence rate between the two groups.Results: In group A, 27 patients (87.0%) were pain free immediately, and 30 patients (96.8%) experienced pain relief at 48 h, whereas that was 37 patients (90.0%) and 40 patients (97.6%) in group B (p ≧ 0.05). Patients in group A who remained an “excellent” or “good” pain relief condition (VAS score ≦ 1) were 96.8% at 6 months, 83.9% at 1 year, 74.2% at 2 years, whereas the percentage in group B was 97.6, 85.4, and 73.2% (p ≧ 0.05).Conclusion: For patients with recurrent TN after PRT, repeated PRT might be considered as a useful treatment option when other treatments fail. In addition, the frequency and severity of adverse events for repeated PRT were similar as compared to initial PRT.

Radiofrequency thermocoagulation for the treatment of trigeminal neuralgia

“…A longer follow-up period was associated with a higher number of relapses. Recurrence following RFT was found in 69.57% of the reported studies and the peak range was 1-2 years (17,18,(20)(21)(22)(24)(25)(26)(27)(28)(29)(30)(31)(32)(34)(35)(36)(37)39,41,46,50,51,(59)(60)(61)(62)(63)(64)(65)12,67). The median value of the mean time to pain recurrence was 26.1±11.5 months (28).…”

“…The percentages of patients experiencing initial pain relief after RFT ranged from 77.8 to 100% (17-24,26-29,31-35,38,40-43,45-48, 50,58,60-66,68), with a mean time to pain recurrence of 8-40 months (24,28,30,31,44,65,67). The recurrence rate following RFT ranged from 0 to 26% (20,25,32,34,39 II) (17,(19)(20)(21)(22)(23)(26)(27)(28)(29)(30)(31)34,35,40,41,45,46,52,58,60,61,(63)(64)(65)(66)69), whereas bothersome dysesthesia occurred in 0-36% of patients (12,18,22,26,28,29,31,…”

“…The recurrence rate following RFT ranged from 0 to 26% (20,25,32,34,39 II) (17,(19)(20)(21)(22)(23)(26)(27)(28)(29)(30)(31)34,35,40,41,45,46,52,58,60,61,(63)(64)(65)(66)69), whereas bothersome dysesthesia occurred in 0-36% of patients (12,18,22,26,28,29,31,33,36,37,(40)(41)(42)45,47,48,50,51,…”

Supraorbital Nerve Radiofrequency for Severe Neuralgia Caused by Herpes Zoster Ophthalmicus

“…Numbness is an unpleasant sensory experience and is also a cause for the low acceptance of nerve impairment methods [ 34 ]. In the present study, all patients had different degrees of numbness after radiofrequency thermocoagulation of the supraorbital nerve, but due to the high selectivity of the supraorbital nerve, numbness was limited to the forehead and the apex and did not affect the motor functions.…”

Impact of combining pulsed and thermal radiofrequency on long-term therapy of idiopathic trigeminal neuralgia: A prospective study

“…Wu et al illustrated that thermocoagulation of the gasserian ganglion is achieved with a technical success of 98-100% [16]. Also, immediate pain relief is described as high as 90-95% in multiple studies [13,23]).…”