Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia

Abstract

Pulsed radiofrequency treatment has been described as a minimal invasive alternative to radiofrequency thermocoagulation for the management of chronic pain syndromes. We present here our first five high-risk patients with idiopathic trigeminal neuralgia who were treated with pulsed radiofrequency after multidisciplinary assessment; with a mean follow-up of 19.2 months (range 10-26). These patients were at high risk due to age, co-morbidities or previous interventional and surgical treatments. An excellent long-term effect was achieved in three of the five patients, a partial effect in one patient and a short-term effect in one patient. No neurological side effects or complications were reported.

Percutaneous Procedures for the Treatment of Trigeminal Neuralgia

“…Erdine and colleagues used pulsed radiofrequency current to treat 5 patients; 3 (60%) experienced durable pain relief and no neurologic complications were observed. 97,98 Percutaneous rhizotomy, in all its forms, offers pain relief for TN that is immediate with varying durability and a generally favorable side effect profile. However, treatment selection remains an inexact science in the absence of high quality outcomes data.…”

Pulsed Radiofrequency Treatment Enhances Dorsal Root Ganglion Expression of Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels in a Rat Model of Neuropathic Pain

“…The current view is that electromagnetic fields generated by PRF can alter neuronal gene expression (Hamann et al 2006). Zundert et al found that PRF upregulates c-fos and downstream genes in spinal dorsal horn neurons (Van Zundert et al 2003), while Hamann et al reported upregulated expression of ATF-3, another widely expressed transcription factor, after PRF (Hamann et al 2006). Hagiwara et al demonstrated that PRF prevents the chemically-induced decrease in norepinephrine-mediated spinal pain inhibition and enhances serotonin-mediated spinal pain inhibition (Hagiwara et al 2009), suggesting that PRF alters genes controlling monoaminergic neuron function or neurotransmission.…”

A prospective study of Gasserian ganglion pulsed radiofrequency combined with continuous radiofrequency for the treatment of trigeminal neuralgia

“…Several authors reported a positive effect of PRF in relieving pain from TN, with no neurological side effects or complications. 1,7 However, in randomized, controlled trials Erdine et al showed that PRF treatment of the GG for TN was not as effective as continuous radiofrequency (CRF) treatment. 8 Exposure time is one of the most important factors affecting the tissue lesion in the CRF technique.…”