Prolonged Pulsed Radiofrequency Treatment in Resistant Trigeminal Neuralgia: A Case Report
Abstract
Trigeminal neuralgia (TN) is one of the most severe painful conditions known to man. Contradictory results regarding the effectiveness of pulsed radiofrequency (PRF) treatment of the trigeminal ganglion have been published in the literature. In the past few years, reports in support of prolonged (extended duration) radiofrequency treatment of the trigeminal ganglion have been emerging. Unlike most other interventional procedures that include nerve or ganglion destruction and its resultant potential complications, PRF treatment is believed to be much safer. Working toward the establishment of effective PRF protocols proves highly valuable in the management of TNs refractory to medical treatment. This article showcases the successful control of two cases of refractory trigeminal neuralgia (TN) through extended duration pulsed radiofrequency treatment. Recent studies, however, suggest prolonged PRF ablation may provide a more durable solution. PRF offers a potentially safer alternative to traditional interventions by minimizing nerve destruction.
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[20] Chua NHL, Halim W, Beems T, Vissers KCP. Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Anesth Pain. 2012; 1(4):257-61.
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[22] Imani F. Using Pulsed Radiofrequency for Chronic Pain. Anesth Pain. 2012; 1(3):155-6.
[23] Sluijter ME, Imani F. Evolution and mode of action of pulsed radiofrequency. Anesthesiol Pain Med. 2013; 2(4):139-41.
[24] Deepak Thapa DN, PDCC VA, Christopher Dass MB, Verma P. Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application. Pain Phys. 2015; 18: e433 5.
[25] Nader A, Bendok BR, Prine JJ, Kendall MC. Ultrasound-guided pulsed radiofrequency application via the pterygopalatine fossa: a practical approach to treat refractory trigeminal neuralgia. Pain Phys. 2015; 18(3): e411-5.
[26] Cheng JS, Lim DA, Chang EF, Barbaro NM. A review of percutaneous treatments for trigeminal neuralgia. Oper Neurosurg. 2014; 10(1):25-33.
[27] Blomstedt PC, Bergenheim AT. Technical difficulties and perioperative complications of retrogasserian glycerol rhizotomy for trigeminal neuralgia. Stereotact Funct Neurosurg. 2003; 79(3-4):168-81.
[28] Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurg. 2001; 48(3):524-34.
[2] Arnold M. Headache classification committee of the international headache society (IHS) the international classification of headache disorders. Cephalalgia. 2018; 38(1):1-211.
[3] HIS (International Headache Society), Classical trigeminal neuralgia, The International Classification of Headache Disorders 3rd edition. [Internet]. 2024. Available from: https://ichd-3.org.
[4] Punyani SR, Jasuja VR. Trigeminal neuralgia: An insight into the current treatment modalities. J Oral Biol Craniofac Res. 2012; 2(3):188-97.
[5] Burchiel, KJ, Trigeminal Neuralgia Surgery: Overview, Preparation, Technique, Medscape. [Internet]. 2019. Available from: https://emedicine.medscape.com/article/248933-overview?form=fpf.
[6] Revuelta-Gutierrez R, Martinez-Anda JJ, Coll JB, Campos-Romo A, Perez-Peña N. Efficacy and safety of root compression of trigeminal nerve for trigeminal neuralgia without evidence of vascular compression. World Neurosurg. 2013; 80(3-4):385-9.
[7] Emril DR, Ho KY. Treatment of trigeminal neuralgia: role of radiofrequency ablation. J Pain Res. 2010; 249-54.
[8] Vallejo R, Benyamin RM, Aliaga L. Radiofrequency vs. pulse radiofrequency: the end of the controversy. Tech Reg Anesth Pain Manag. 2010; 14(3):128-32.
[9] Eugene AR. Trigeminal neuralgia and radiofrequency lesioning. Brain: broad research in artificial intelligence and neuroscience. 2015; 6(1-2):91.
[10] Ying X, Wang H, Deng S, Chen Y, Zhang J, Yu W. Long-term outcome of percutaneous balloon compression for trigeminal neuralgia patients elder than 80 years: a STROBE-compliant article. Med. 2017; 96(39): e8199.
[11] Wu H, Zhou J, Chen J, Gu Y, Shi L, Ni H. Therapeutic efficacy and safety of radiofrequency ablation for the treatment of trigeminal neuralgia: a systematic review and meta-analysis. J Pain Res. 2019; 423-41.
[12] Van Zundert J, Brabant S, Van de Kelft E, Vercruyssen A, Van Buyten JP. Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia. Pain. 2003; 104(3):449-52.
[13] Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, Disci R. Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur J Pain. 2007; 11(3):309-13.
[14] Wolf A, Kondziolka D. Gamma knife surgery in trigeminal neuralgia. eurosurg Clin. 2016; 27(3):297-304.
[15] Spina A, Mortini P, Alemanno F, Houdayer E, Iannaccone S. Trigeminal neuralgia: toward a multimodal approach. World Neurosurg. 2017; 103:220-30.
[16] Siddiqui MN, Siddiqui S, Ranasinghe SJ, Furgang AF. Pain management: trigeminal neuralgia. Hosp Physician. 2000; 1:64-70.
[17] Lopez BC, Hamlyn PJ, Zakrzewska JM. Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurg. 2004; 54(4):973-82.
[18] Arakawa K, Kaku R, Kurita M, Matsuoka Y, Morimatsu H. Prolonged-duration pulsed radiofrequency is associated with increased neuronal damage without further antiallodynic effects in neuropathic pain model rats. J Pain Res. 2018; 11:2645.
[19] Sluijter ME. Radiofrequency. FlivoPress, 2001.
[20] Chua NHL, Halim W, Beems T, Vissers KCP. Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Anesth Pain. 2012; 1(4):257-61.
[21] Maurer AJ, Candido KD, Knezevic NN. Radiofrequency Treatment. Pain: A Review Guide. 2019; 869-72.
[22] Imani F. Using Pulsed Radiofrequency for Chronic Pain. Anesth Pain. 2012; 1(3):155-6.
[23] Sluijter ME, Imani F. Evolution and mode of action of pulsed radiofrequency. Anesthesiol Pain Med. 2013; 2(4):139-41.
[24] Deepak Thapa DN, PDCC VA, Christopher Dass MB, Verma P. Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application. Pain Phys. 2015; 18: e433 5.
[25] Nader A, Bendok BR, Prine JJ, Kendall MC. Ultrasound-guided pulsed radiofrequency application via the pterygopalatine fossa: a practical approach to treat refractory trigeminal neuralgia. Pain Phys. 2015; 18(3): e411-5.
[26] Cheng JS, Lim DA, Chang EF, Barbaro NM. A review of percutaneous treatments for trigeminal neuralgia. Oper Neurosurg. 2014; 10(1):25-33.
[27] Blomstedt PC, Bergenheim AT. Technical difficulties and perioperative complications of retrogasserian glycerol rhizotomy for trigeminal neuralgia. Stereotact Funct Neurosurg. 2003; 79(3-4):168-81.
[28] Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurg. 2001; 48(3):524-34.
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| Section | Case Report(s) | |
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| Pain Management Prolonged Pulsed Radiofrequency Extended Duration Pulsed Radiofrequency Trigeminal Neuralgia Trigeminal Ganglion | ||
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How to Cite
1.
Hashemi SM, Behnaz F, Hassannasab S, Asgari S. Prolonged Pulsed Radiofrequency Treatment in Resistant Trigeminal Neuralgia: A Case Report. Arch Anesth & Crit Care. 2025;.
