Treatment of trigeminal neuralgia by radiofrequency of the Gasserian ganglion
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Jinwan Guo
Abstract
Trigeminal neuralgia (TN) is a neuropathic pain disorder that affects the trigeminal nerve distribution area. Pharmacological therapy has remained the first-line treatment for TN. If pharmacological intervention is not effective, surgical treatments including radiosurgery (mainly gamma knife therapy), radiofrequency (RF) of the Gasserian ganglion, and microvascular decompression have been utilized. RF is one of the most common procedures used to treat TN. Two RF approaches are commonly utilized: conventional radiofrequency (CRF) and pulsed radiofrequency (PRF). Both methods have been used to successfully treat TN; however, each procedure has distinct advantages and disadvantages. This article summarizes the current relevant literature to compare the treatment of TN with CRF vs. PRF. We discuss the treatment indications, operative methods, and complications of each treatment strategy. Most of the patients treated with CRF had a satisfactory outcome, whereas most PRF patients still had significant pain after the procedure. The application of a higher voltage can improve the curative effect of PRF, and its complications are less than CRF. Both CRF and PRF can be used to treat TN, and the former was more effective. Although the complications of CRF are more than those of PRF, most of them were short-lived and lacked sequelae. The pain relief rate in PRF-treated patients was significantly lower compared to CRF-treated patients. Furthermore, recurring pain was more commonly observed in PRF-treated patients. Therefore, CRF may be the preferred treatment option for TN, whereas treatment with PRF requires further study.
Conflict of interest statement: The authors declare no competing financial interest.
Source of financial support: Supported by the Scientific Research Foundation of Shandong Province of Outstanding Young Scientist Award (BS2013 YY047) and Postdoctoral Science Foundation of China (2014M551922) to Xuli Zhao.
References
Ali, S. and Murat, S. (2010). Subarachnoid bleeding into the superior cerebellopontine cistern after radiofrequency trigeminal rhizotomy: case report. Acta Neurochir. 152, 561–562.10.1007/s00701-009-0483-2Suche in Google Scholar PubMed
Bing, H., Ming, Y., Zhiying, F., Jianguo, G., Arzhang, Z., Michael, L., and Xiang, Q. (2014). CT-guided percutaneous infrazygomatic radiofrequency neurolysis through foramen rotundum to treat V2 trigeminal neuralgia. Pain Med. 15, 1418–1428.10.1111/pme.12440Suche in Google Scholar PubMed
Dessy, R.E. and Ho, K.Y. (2010). Treatment of trigeminal neuralgia: role of radiofrequency ablation. J. Pain Res. 3, 249–254.10.2147/JPR.S14455Suche in Google Scholar
Fang, L., Ying, S., Tao, W., Lan, M., Xiaotong, Y., and Nan, J. (2014a). 3D CT-guided pulsed radiofrequency treatment for trigeminal neuralgia. Pain Pract. 14, 16–21.10.1111/papr.12041Suche in Google Scholar PubMed
Fang, L., Tao, W., Jingjing, L., and Nan, J. (2014b). Comparison of high-voltage- with standard-voltage pulsed radiofrequency of Gasserian ganglion in the treatment of idiopathic trigeminal neuralgia. Pain Pract. 15, 595–603.10.1111/papr.12227Suche in Google Scholar PubMed
Girija, P.R., Hari, H.D., Parmod, K.B., and Vinay, G. (2009). Intracranial hemorrhage after percutaneous radiofrequency trigeminal rhizotomy. Pain Pract. 9, 82–84.10.1111/j.1533-2500.2008.00246.xSuche in Google Scholar PubMed
Huibin, Q., Jianxing, L., Guangyu, H., and Dianen, F. (2009). The treatment of first division idiopathic trigeminal neuralgia with radiofrequency thermocoagulation of the peripheral branches compared to conventional radiofrequency. J. Clin. Neurosci. 16, 1425–1429.10.1016/j.jocn.2009.01.021Suche in Google Scholar PubMed
Jae, H.K., Hee, Y.Y., Soo, Y.P., Sang, C.L., and Yong, C.K. (2013). Pulsed and conventional radiofrequency treatment: which is effective for dental procedure-related symptomatic trigeminal neuralgia? Pain Med. 14, 430–435.10.1111/pme.12046Suche in Google Scholar PubMed
Jason S.C., Daniel A.L., Edward F.C., and Nicholas M.B. (2014). A review of percutaneous treatments for trigeminal neuralgia. Oper. Neurosurg. 10, 25–33.10.1227/NEU.00000000000001687Suche in Google Scholar PubMed
Jean, R., Constantin, T., Noémie, R., Romain, C., Anne, D., Shoji, Y., Jean, G., and Marc, L. (2016). The very long-term outcome of radiosurgery for classical trigeminal neuralgia. Stereotact. Funct. Neurosurg. 94, 24–32.10.1159/000443529Suche in Google Scholar PubMed
Kanpolat, Y., Savas, A., Bekar, A., and Berk, C. (2001). Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. Neurosurg. 48, 524–532.10.1097/00006123-199909000-00209Suche in Google Scholar
Luo, F., Meng, L., Wang, T., Yu, X., Shen, Y., and Ji, N. (2013). Pulsed radiofrequency treatment for idiopathic trigeminal neuralgia: a retrospective analysis of the causes for ineffective pain relief. Eur. J. Pain 17, 1189–1192.10.1002/j.1532-2149.2012.00278.xSuche in Google Scholar
Madan, N., Kumaraswamy, S.V., Keerthi, R., Ashwin, A.L., Gopinath, M.A., Reyazulla, K.B., and Hemavathi. (2013). Percutaneous radiofrequency rhizotomy in treatment of trigeminal neuralgia: a prospective study. Maxillofac. Oral. Surg. 12, 35–41.10.1007/s12663-012-0365-7Suche in Google Scholar
Maite, B., Miguel, P., María, P., and Ana, C. (2013). Conventional radiofrequency treatment in five patients with trigeminal neuralgia. Med. Oral. Patol. Oral. Cir. Bucal. 18, 76–80.10.4317/medoral.17372Suche in Google Scholar
Mario, Ff., Benedetto, C., Laura, M., Guglielmo, C., and Chiara, F. (2009). Validity of percutaneous controlled radiofrequency thermocoagulation in the treatment of isolated third division trigeminal neuralgia. Surg. Neurol. 71, 180–183.10.1016/j.surneu.2007.09.024Suche in Google Scholar
Melih, B., Eyyub, S.M.A., Mevci, O., Mevci, O., Gokmen, K., Atilla, H.E., Ali, S., and Yucel, K. (2012). Management of bilateral trigeminal neuralgia with trigeminal radiofrequency rhizotomy: a treatment strategy for the life-long disease. Acta Neurochir. 154, 785–792.10.1007/s00701-012-1311-7Suche in Google Scholar
Michelle, N. and Denise, W. (2010). Pulsed radiofrequency V2 treatment and intranasal sphenopalatine ganglion block: a combination therapy for atypical trigeminal neuralgia. Pain Pract. 10, 370–374.10.1111/j.1533-2500.2010.00382.xSuche in Google Scholar
Nicholas, H.L.C., Willy, H, Tjemme, B., and Kris, C.P.V. (2012). Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth. Pain. 1, 257–261.10.5812/aapm.3493Suche in Google Scholar
Nurmikko, T.J. and Eldridge, P.R. (2001). Trigeminal neuralgia-pathophysiology, diagnosis and current treatment. Br. J. Anaesth. 87, 117–132.10.1093/bja/87.1.117Suche in Google Scholar
Qingli, M., Wenhua, Z., Yang, Y., Maode, Z., and Xingang, L. (2008). Cardiovascular responses during percutaneous radiofrequency thermocoagulation therapy in primary trigeminal neuralgia. Neurosurg. Anesthesiol. 20, 131–135.10.1097/ANA.0b013e3181628305Suche in Google Scholar
Robert, A.E., Misha, P., and William, T.S. (2001). Monocular blindness as a complication of trigeminal radiofrequency rhizotomy. Am. J. Ophthalmol. 131, 237–240.10.1016/S0002-9394(00)00796-0Suche in Google Scholar
Sarita, S., Reetu, V., Manoj, K., Virendra, R., and Jaishree, B. (2014). Experience with conventional radiofrequency thermorhizotomy in patients with failed medical management for trigeminal neuralgia. Korean J. Pain 27, 260–265.10.3344/kjp.2014.27.3.260Suche in Google Scholar PubMed PubMed Central
Serdar, E., Nuri, S.O., Ali, C., Mehmet, C., Gul, K.T., and Rian, D. (2007). Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur. J. Pain 11, 309–313.10.1016/j.ejpain.2006.04.001Suche in Google Scholar PubMed
Shizuko, K., Masahiro, S., Yasuhisa, O., Takeshi, S., Nobuyuki, K., Saori, H., and Hiroshi, M. (2015). Long-term outcomes of percutaneous radiofrequency thermocoagulation of Gasserian ganglion for 2nd- and multiple-division trigeminal neuralgia. Pain Prac. 15, 223–228.10.1111/papr.12163Suche in Google Scholar PubMed
Teixeira, M.J., Siqueira, S.R.D.T., and Almeida, G.M. (2006). Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain. Arq Neuropsiquiatr. 64, 983–989.10.1590/S0004-282X2006000600018Suche in Google Scholar PubMed
Xuanying, L., Jiaxiang, N., Liqiang, Y., Baishan, W., Mingwei, H., Xiushuang, Z., Ling, M., and Haiyan, S. (2012). A prospective study of Gasserian ganglion pulsed radiofrequency combined with continuous radiofrequency for the treatment of trigeminal neuralgia. J. Clin. Neurosci. 19, 824–828.10.1016/j.jocn.2011.07.053Suche in Google Scholar PubMed
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Schizophrenia: the role of sleep and circadian rhythms in regulating dopamine and psychosis
- Incretin-based therapy for type 2 diabetes mellitus is promising for treating neurodegenerative diseases
- Developmental implications of children’s brain networks and learning
- Neural substrates and potential treatments for levodopa-induced dyskinesias in Parkinson’s disease
- Treatment of trigeminal neuralgia by radiofrequency of the Gasserian ganglion
- S100B raises the alert in subarachnoid hemorrhage
- Use of electrospinning to construct biomaterials for peripheral nerve regeneration
Artikel in diesem Heft
- Frontmatter
- Schizophrenia: the role of sleep and circadian rhythms in regulating dopamine and psychosis
- Incretin-based therapy for type 2 diabetes mellitus is promising for treating neurodegenerative diseases
- Developmental implications of children’s brain networks and learning
- Neural substrates and potential treatments for levodopa-induced dyskinesias in Parkinson’s disease
- Treatment of trigeminal neuralgia by radiofrequency of the Gasserian ganglion
- S100B raises the alert in subarachnoid hemorrhage
- Use of electrospinning to construct biomaterials for peripheral nerve regeneration
