Comparison of the Efficacy of Short-term Peripheral Nerve Stimulation and Pulsed Radiofrequency for Treating Herpes Zoster Ophthalmicus Neuralgia

Abstract

Objective: This study aimed to investigate the effect of therapy with peripheral nerve stimulation (PNS) and pulsed radiofrequency (PRF) combined or PNS and PRF separately in patients with herpes zoster ophthalmicus (HZO). Materials and Methods: This cohort study included 106 cases of HZO. Three groups were identified according to the type of treatment received: combination therapy (PNS+PRF) (n=38), PRF (n=37), and PNS (n=31). The observations at 0, 1, 2, and 4 weeks; 3 and 6 months; and 1 and 2 years after the operation were analyzed. Observations at each follow-up included baseline characteristics, Numerical Rating Scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI), concomitant pain medication usage, relapse rate, and adverse events. Results: The postoperative NRS of all 3 groups were significantly lower than preoperative scores. The PSQI of the 3 groups was significantly improved postoperatively, and the concomitant pain medication gradually decreased. Regarding long-term efficacy, the pain NRS and PSQI scores of the PNS+PRF and PNS groups were significantly lower than those of the PRF group (P<0.05), and the relapse rate of the PRF group was higher than that of the PNS+PRF and PNS groups (P<0.05). No significant difference was observed between the PNS+PRF and the PNS groups. Conclusion: Both PNS and PRF treatment of HZO can decrease the pain score, yielding no serious complications. The combination of PNS and PRF or PNS alone resulted in more significant pain relief than treatment with PRF alone. Thus, PNS therapy may be a better treatment option for HZO.

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report

“…Likely, persistent electrical stimulation of trigeminal nerve branch combined with or without pulsed radiofrequency modulation demonstrated to achieve superior clinical efficacy than separate pulsed radiofrequency. 5 However, it remains controversial about therapeutic superiority of electrical nerve stimulation over radiofrequency, due to lack of high-quality data from well-designed clinical trial. In addition, radiofrequency alone may provide considerable relief of herpetic neuralgia compared with other conservative oral medication.…”

“…In future, pain treatment approaches perhaps will take full advantage of multimode neuromodulation strategy in terms of stimulation site, novel high frequency or bursting stimulation parameter, and as in this case, combination of dual or multiple neuromodulation devices to treat intractable pain. 4 – 6 , 13 , 14 …”

“…1 In most cases, single mode of neuromodulation is applied to seek pain relief; recently, emerging evidence has demonstrated that combination of distinct pattern of modulatory strategy can provide satisfactory control of neuropathic pain. [4][5][6] Here, we present a case of severe lower limb pain caused by postherpetic neuralgia. A new dual function DRG stimulator was implanted to provide DRG electrical stimulation and pulsed radiofrequency neuromodulation.…”

“… 1 In most cases, single mode of neuromodulation is applied to seek pain relief; recently, emerging evidence has demonstrated that combination of distinct pattern of modulatory strategy can provide satisfactory control of neuropathic pain. 4 – 6 …”

An Insight into Neuromodulation for Treating Herpes Zoster Ophthalmicus Neuralgia

“…We read with great interest the article "Comparison of the Efficacy of Short-term Peripheral Nerve Stimulation and Pulsed Radiofrequency for Treating Herpes Zoster Ophthalmicus Neuralgia" by Xiaochong and colleagues, published in the November 2022 issue. 1 We commend the authors for comparing the effectiveness of different forms of neuromodulation in herpes zoster neuralgia. However, there are few issues we would like to address.…”