Impact of combining pulsed and thermal radiofrequency on long-term therapy of idiopathic trigeminal neuralgia: A prospective study

Abstract

Background: Trigeminal neuralgia (TN) is a painful condition characterized by sudden onset, severe unilateral, brief, stabbing recurrent episodes electric shock like pain in the distribution of one or more branches of the trigeminal nerve. Many approaches were used for treatment of TN as balloon decompression, thermocoagulation radiofrequency (TRF), and pulsed radiofrequency (PRF). Objectives: This study evaluated the effectiveness of combined PRF and TRF for long-term therapy of patients with idiopathic TN. Patient and methods: Our prospective study was carried out after the approval of ethical committee of Zagazig University Hospital Pain Management Unit from June 2017 to May2019. Overall, 20 adult patients suffering from idiopathic TN who treated with combining PRF and TRF for the gasserian ganglion. PRF (continuous for 20 min, at 42°C) followed by TRF (for 60 s at 70°C, then for 60 s, at 75°C) was performed to the gasserian ganglion. The post-operative pain relief and complications were evaluated at first day, 1, 3, 6, 12, 18, and 24 months after treatment. Results: There were significant improvements of pain relief as regards Visual Analog Scale showed baseline VAS [8.65 ± 0.59] and first day, 1, 3, 6, 12, 18, 24 months [3.60 ± 1.09, 2.55 ± 0.69, 1.7 ± 0.65, 1.05 ± 0.68, 0.85 ± 0.67, 0.80 ± 0.69, 0.9 ± 0.69], respectively, facial numbness and postoperative masseter muscle weakness recovered more rapidly in patients receiving combined PRF and TRF therapy. Conclusion: Combination of PRF followed by TRF is effective in treating TN pain with minimal postoperative complications.