Ultrasonic lesion of the trigeminal nucleus caudalis for deafferentation facial pain

Grigoryan, Yu A; Slavin, Konstantin V.; Ogleznev, K. Ya.

doi:10.1007/bf01808619

Cited by 16 publications

(10 citation statements)

References 33 publications

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“…Surgical alternatives to extend the duration of relief, such as stereotactic radiosurgical treatment of SPG neuralgia, have also been reported 14 . Ipsilateral facial paresis following ultrasonic lesioning of the trigeminal nucleus caudalis for deafferentation facial pain has been reported 15 …”

Section: Discussionmentioning

confidence: 99%

Sphenopalatine Ganglion Pulsed Radiofrequency Treatment in 30 Patients Suffering from Chronic Face and Head Pain

et al. 2005

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This study evaluated the efficacy of sphenopalatine ganglion pulsed radiofrequency (SPG-PRF) treatment in patients suffering from chronic head and face pain. Thirty patients were observed from 4 to 52 months after PRF treatment. The primary efficacy measures were the reduction in oral medication use, including opioids, time-to-next-treatment modality for presenting symptoms, duration of pain relief, and the presence of residual symptoms. Secondary objectives included the evaluation of adverse effects and complications. All data were derived from patient charts, phone conversations, and clinical follow-up visits. Fourteen percent of respondents reported no pain relief, 21% had complete pain relief, and 65% of the patients reported mild to moderate pain relief from SPG-PRF treatment. Sixty-five percent of the respondents reported mild to moderate reduction in oral opioids. None of the patients developed significant infection, bleeding, hematoma formation, dysesthesia, or numbness of palate, maxilla, or posterior pharynx. A large-scale study of SPG-PRF for the treatment of face and head pain has not been previously reported. Our results suggest that a prospective, randomized, controlled trial study to confirm efficacy and safety of this novel treatment for chronic head and face pain is justified.

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Section: Discussionmentioning

confidence: 99%

Sphenopalatine Ganglion Pulsed Radiofrequency Treatment in 30 Patients Suffering from Chronic Face and Head Pain

et al. 2005

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“…Instead, a series of lesions are made below the level of the fourth ventricle and extending to the C 2 dorsal nerve roots. Many variations of the DREZ lesioning technique have since been used, including using laser[16] energy, using ultrasonic energy,[9] and broadening the nucleus caudalis lesion width by using a double-row of lesions. [24] Kanpolat innovated a CT guided percutaneous technique for single nucleotomy lesion placement.…”

Section: Discussionmentioning

confidence: 99%

Nucleus caudalis lesioning: Case report of chronic traumatic headache relief

Sandwell

El-Naggar²

2011

Surg Neurol Int

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Background:The nucleus caudalis dorsal root entry zone (DREZ) surgery is used to treat intractable central craniofacial pain. This is the first journal publication of DREZ lesioning used for the long-term relief of an intractable chronic traumatic headache.Case Description:A 40-year-old female experienced new-onset bi-temporal headaches following a traumatic head injury. Despite medical treatment, her pain was severe on over 20 days per month, 3 years after the injury. The patient underwent trigeminal nucleus caudalis DREZ lesioning. Bilateral single-row lesions were made at 1-mm interval between the level of the obex and the C2 dorsal nerve roots, using angled radiofrequency electrodes, brought to 80°C for 15 seconds each, along a path 1 to 1.2 mm posterior to the accessory nerve rootlets. The headache improved, but gradually returned. Five years later, her headaches were severe on over 24 days per month. The DREZ surgery was then repeated. Her headaches improved and the relief has continued for 5 additional years. She has remained functional, with no limitation in instrumental activities of daily living.Conclusions:The nucleus caudalis DREZ surgery brought long-term relief to a patient suffering from chronic traumatic headache.

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“…Nevertheless, complications were mostly major; Hitchcock et al [38] reported at least one of the following complications in all three patients (100%) including ipsilateral facial and contralateral arm and body sensory loss. Also, the study by Grigoryan et al [35] which used ultrasonic nucleus caudalis destruction reported complications in 75% (3/4) of patients including contralateral body sensory loss, ataxia and Brown-Sequard syndrome. Chivukula et al [23] reported one incidence of neuropathy/radiculopathy among the three patients who had caudalis DREZ lesioning.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies comprising 63 patients with resistant trigeminal PHN to medical therapy were identified from the literature review [23, 35-38]. Four studies performed caudalis DREZ lesioning/stereotactic nucleotomy-nucleotractotomy using a radiofrequency generator, and 1 study performed ultrasonic destruction of the nucleus caudalis 4 months to 4.5 years following zoster onset.…”

Section: Resultsmentioning

confidence: 99%

Neurosurgeons’ Armamentarium for the Management of Refractory Postherpetic Neuralgia: A Systematic Literature Review

Texakalidis

Tora

Boulis

2019

Stereotact Funct Neurosurg

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Background/Aims: Postherpetic neuralgia (PHN) can be refractory to both medical and minimally invasive treatments. Its complex pathophysiology explains the numerous neurosurgical procedures that have been implemented through the years. Our objective was to summarize all available neurosurgical strategies for the management of resistant PHN and evaluate their respective safety and efficacy outcomes. Methods: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 38 studies comprising 811 patients with refractory PHN were included. The safety and efficacy of the following procedures were investigated: spinal cord stimulation (SCS), dorsal root entry zone (DREZ) lesioning, intrathecal drug delivery, caudalis DREZ lesioning, dorsal root ganglion (DRG) radiofrequency lesioning, peripheral nerve stimulation, gamma knife surgery, deep brain stimulation, cordotomy, percutaneous radiofrequency rhizotomy and Gasserian ganglion stimulation. Conclusions: There are several available neurosurgical approaches for recalcitrant PHN including neuromodulatory and ablative procedures. It is suggested that patients with resistant PHN undergo minimally invasive procedures first, including SCS, peripheral nerve stimulation or DRG radiofrequency lesioning. More invasive procedures should be reserved for refractory cases. Comparative studies are needed in order to construct a PHN neurosurgical management algorithm.

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Ultrasonic lesion of the trigeminal nucleus caudalis for deafferentation facial pain

Cited by 16 publications

References 33 publications

Sphenopalatine Ganglion Pulsed Radiofrequency Treatment in 30 Patients Suffering from Chronic Face and Head Pain

Sphenopalatine Ganglion Pulsed Radiofrequency Treatment in 30 Patients Suffering from Chronic Face and Head Pain

Nucleus caudalis lesioning: Case report of chronic traumatic headache relief

Neurosurgeons’ Armamentarium for the Management of Refractory Postherpetic Neuralgia: A Systematic Literature Review

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