Radiofrequency Ablation for Treating Headache

Abd‐Elsayed, Alaa; Nguyen, Sean; Fiala, Kenneth

doi:10.1007/s11916-019-0755-3

Cited by 20 publications

(11 citation statements)

References 16 publications

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“…Other lesser invasive approaches such as cryotherapy ("frotox") or targeted radiofrequency ablation have been described in the surgical aesthetic literature to obtain long term denervation of the CSM and may be worth investigating for the treatment of ITNp distributed in the SSd in the future in a subset of patients [29][30][31]. The surgical technique herein described remains superior in our opinion due to the achievement of permanent results.…”

Section: Discussionmentioning

confidence: 90%

Selective denervation of the corrugator supercilii muscle for the treatment of idiopatic trigeminal neuralgia purely paroxysmal distributed in the supraorbital and suprathrochlear dermatomes

et al. 2021

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Introduction Idiopatic trigeminal neuralgia purely paroxysmal (ITNp) distributed in the supraorbital and suprathrochlear dermatomes (SSd), refractory to conventional treatments have been linked to the hyperactivity of the corrugator supercilii muscle (CSM). In these patients, the inactivation of the CSM via botulinum toxin type A (BTA) injections has been proven to be safe and effective in reducing migraine burden. The main limitation of BTA is the need of repetitive injections and relative high costs. Based on the study of the motor innervation of the CSM, we describe here an alternative approach to improve these type of migraines, based on a minimally invasive denervation of the CSM. Materials and methods Motor innervation and feasibility of selective CSM denervation was first studied on fresh frozen cadavers. Once the technique was safely established, 15 patients were enrolled. To be considered eligible, patients had to meet the following criteria: positive response to BTA treatment, migraine disability assessment score > 24, > 15 migraine days/month, no occipital/temporal trigger points and plausible reasons to discontinue BTA treatment. Pre- and post- operative migraine headache index (MHI) were compared, and complications were classified following the Clavien-Dindo classification (CDC). Results Fifteen patients (9 females and 6 males) underwent the described surgical procedure. The mean age was 41 ± 10 years. Migraine headache episodes decreased from 24 ± 4 day/month to 2 ± 2 (p < 0.001) The MHI decreased from 208 ± 35 to 10 ± 11 (p < 0.001). One patient (7%) had a grade I complication according to the CDC. No patient needed a second operative procedure. Conclusions Our findings suggest that the selective CSM denervation represents a safe and minimally invasive approach to improve ITNp distributed in the SSd associated with CSM hyperactivation. Trial registration The data collection was conducted as a retrospective quality assessment study and all procedures were performed in accordance with the ethical standards of the national research committee and the 1964 Helsinki Declaration and its later amendments.

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Section: Discussionmentioning

confidence: 90%

Selective denervation of the corrugator supercilii muscle for the treatment of idiopatic trigeminal neuralgia purely paroxysmal distributed in the supraorbital and suprathrochlear dermatomes

et al. 2021

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“…RF ablation is a procedure that generates heat to a specific temperature creating a lesion to a target nerve, resulting in selectively destroying A-delta and C pain fibers. Radiofrequency ablation has been found to be a safe and effective treatment for chronic headaches [33][34][35]. A retrospective study of 46 patients who underwent thermal RF ablation of the GON and LON found significant reductions in pain scores (6.7 vs 2.7, respectively; P < 0.001) with the mean patient-defined percent pain relief of 76.3% ± 25.0%.…”

Section: Radiofrequency Ablation and Cryoneurolysismentioning

confidence: 99%

Occipital Neuralgia

Pan

Peng

Elmofty

2021

Curr Pain Headache Rep

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Purpose of Review Occipital neuralgia is a painful condition that affects the posterior aspect of the head and can be difficult to distinguish from other common forms of headaches. This article reviews the anatomy, pathophysiology, clinical presentation, differential diagnosis, diagnostic testing, and management approaches for occipital neuralgia. Recent Findings Non-pharmacological treatments aim to alleviate muscle tension and improve posture. Acupuncture shows some promise. The occipital nerve block is considered the first line in a minimally invasive intervention, but the duration of relief may be short term. An onabotulinum toxin A injection may improve the sharp but not the dull component of the pain of occipital neuralgia. Radiofrequency ablation and occipital nerve stimulation may provide effective long-term relief in refractory patients. Surgical decompression, neurotomies, and neurolysis are last-resort treatment options. Summary Occipital neuralgia is a debilitating condition that can be difficult to treat. Studies with larger sample sizes and randomized control trials are needed to further determine the effectiveness and safety of different therapies.

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“…Compared to laser, RF had an additional advantage in protecting vaginal tissues due to electromagnetic wave heat generated through the tissue impedance in vaginal tissue [ 20 , 21 ]. RF had some positive effects on stress urinary incontinence [ 22 ], vaginal laxity [ 14 ], skin rejuvenation [ 23 ], headache [ 24 ], and cardiac arrhythmias [ 25 ]. In this study, a temperature controlled dual-mode (monopolar and bipolar) RF was applied to patients with vaginal laxity, and its efficacy and safety were evaluated to determine the treatment satisfaction.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of temperature controlled dual-mode radiofrequency in women with vaginal laxity

Long

Qin

et al. 2023

BMC Women's Health

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Objective Vaginal laxity could negatively influence women’s sexual function. This study aimed to explore the efficacy and safety of temperature controlled dual-mode (monopolar and bipolar) radiofrequency (RF) in women with vaginal laxity. Methods A total of 102 patients with vaginal laxity were treated with temperature-controlled RF. The present study implemented Vaginal Laxity Questionnaire (VLQ), Female Sexual Function Index (FSFI) questionnaire and Sexual Satisfaction Questionnaire (SSQ) on all patients at baseline and after treatment. Pelvic Organ Prolapse Quantification System (POP-Q) system was applied to physical examination, and vaginal manometer to examine the strength of voluntary contractions of the pelvic floor muscles. Results The VLQ score was gradually increased after RF treatment at 1, 3, 6 and 12 months, accompanying by the significant improvement in total FSFI scores and the six domains (sexual desire, sexual arousal, lubrication, orgasm, satisfaction, pain). The increased sexual satisfaction based on the SSQ score was found after temperature-controlled RF. The result of POP-Q stage showed significant difference in women after treatment, with the women having Stage I of 45.10% at baseline, 36.27% at 1 month, 28.43% at 3 months, 19.61% at 6 months and 10.78% at 12 months. The mean pressure and mean duration of pelvic contractions were increased gradually at the 1-, 3-, 6- and 12- month follow-up. Conclusion Temperature controlled dual-mode (monopolar and bipolar) radiofrequency may be associated with improvement of vaginal laxity, and contribute to enhancement to female sexual function and pelvic floor muscles.

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Radiofrequency Ablation for Treating Headache

Cited by 20 publications

References 16 publications

Selective denervation of the corrugator supercilii muscle for the treatment of idiopatic trigeminal neuralgia purely paroxysmal distributed in the supraorbital and suprathrochlear dermatomes

Selective denervation of the corrugator supercilii muscle for the treatment of idiopatic trigeminal neuralgia purely paroxysmal distributed in the supraorbital and suprathrochlear dermatomes

Occipital Neuralgia

The efficacy and safety of temperature controlled dual-mode radiofrequency in women with vaginal laxity

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