Subcutaneous trigeminal nerve field stimulation for refractory trigeminal pain: a cohort analysis

Jakobs, Martin; Unterberg, Andreas; Treede, Rolf‐Detlef; Schuh‐Hofer, Sigrid; Ahmadi, Rezvan

doi:10.1007/s00701-016-2881-6

Cited by 31 publications

(25 citation statements)

References 20 publications

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“…There was 1 patient with infection and 2 required reprogramming of stimulation due to side effects. 45 In another study, there were 4 patients were suffering from recurrent CTN; 1 had CTN and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, 1 from post-herpetic neuropathy, 1 from trigeminal neuropathy following radiation therapy, and 1 from persistent idiopathic facial pain.…”

Section: Peripheral Nerve Stimulationmentioning

confidence: 99%

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Neuromodulation and Devices in Trigeminal Neuralgia

Weber

2017

Headache

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We review several devices including neuromodulation, ranging in invasiveness, for treatment of trigeminal neuralgia and neuropathy. We review existing data on sphenopalatine ganglion blocks, transcranial magnetic stimulation, transcortical direct stimulation, deep brain stimulation, spinal cord stimulation, peripheral nerve stimulation, and transcutaneous electrical stimulation for CTN and pain trigeminal neuropathies. We also offer hope for further research in this area with the goal of discovering a device that can provide treatment for many with few side effects and minimal morbidity.

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Section: Peripheral Nerve Stimulationmentioning

confidence: 99%

“…The number of attacks decreased by a mean of 73% with SD of 26%. There was 1 patient with infection and 2 required reprogramming of stimulation due to side effects …”

Section: Introductionmentioning

confidence: 99%

Neuromodulation and Devices in Trigeminal Neuralgia

Weber

2017

Headache

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“…SCS treatment of pain syndromes after incomplete spinal cord injuries is less successfull. In regional pain conditions, sPNS plays an increasingly important role and recent attempts of treating trigeminal pain with sPNS have been successful [39]. Should these surgical procedures fail, two invasive brain stimulation methods are available as a last resort.…”

Section: Invasive Pain Managementmentioning

confidence: 99%

New Results on Brain Stimulation in Chronic Pain

Antal¹,

Paulus²,

Rohde

2017

Neurology International Open

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Chronic pain induces a change of the anatomical pain network, primarily comprising DLPFC, M1, somatosensory cortex, the anterior cingulate cortex, and the thalamus. In patients with chronic back pain, a progressive decrease in neocortical gray matter (DLPFC) of 5-11 % compared to healthy subjects is observed over the years [8]. Per pain year the loss of gray matter density was approximately 1.3 cm 3 .

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“…Where all these measures are ineffective, or where medication causes intolerable side-effects, neuromodulation may be an option. Stimulation has been applied at a range of sites, including peripherally using subcutaneous electrodes in the face (2)(3)(4)(5)(6)(7)(8)(9), at the Gasserian ganglion (10)(11)(12), and centrally with high cervical spinal cord stimulation (targeting the spinal trigeminal nucleus) (13)(14)(15), deep brain stimulation (16) (targeting the ventroposteromedial nucleus of the thalamus and/or the periaqueductal gray matter), or motor cortex stimulation (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Burst or Conventional Peripheral Nerve Field Stimulation for Treatment of Neuropathic Facial Pain

Manning

Ortega

Moir

et al. 2019

Neuromodulation: Technology at the Neural Interface

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Background Trigeminal Neuropathic Pain (TNP) is a chronic facial pain syndrome caused by a lesion or disease affecting one or more branches of the trigeminal nerve. It may, for example, result from accidental injury to a branch of the trigeminal nerve by trauma or during surgery; it may also be idiopathic. TNP is typically constant, in contrast to most cases of the commoner trigeminal neuralgia. In some cases, pain may be refractory to pharmacological treatment. Peripheral nerve field stimulation is recognized as an effective minimally invasive surgical treatment option for this debilitating condition. To date, stimulation has used conventional tonic waveforms, which generate paraesthesia in the stimulated area. This is the first report of the use of paraesthesia‐free burst pattern stimulation for TNP. Methods Seven patients were treated at the John Radcliffe Hospital for TNP from 2016 to 2018. Mean duration of preoperative symptoms was five years. All patients had exhausted pharmacological measures to limited effect. The initial three patients had tonic stimulation with the subsequent four having burst stimulation. Outcome was assessed using the numeric pain rating scale preoperatively and postoperatively at three and six months and one year. Side‐effects and complications were also assessed as well as reduction in analgesic medication use. Results All patients achieved pain reduction of at least 50% at 6 months (range 50–100%, mean 81%, p = 0.0082). Those in the burst stimulation group were paraesthesia free. One patient developed a postoperative infection for which the system had to be removed and is awaiting reimplantation. There were no other complications in either group. Conclusion Burst stimulation conferred similar pain control to tonic stimulation in our small cohort, and there were similar reductions in pain medication use. An additional benefit of burst stimulation is freedom from paraesthesia. Larger scale studies are needed to further evaluate burst stimulation and compare its efficacy with that of tonic stimulation.

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Subcutaneous trigeminal nerve field stimulation for refractory trigeminal pain: a cohort analysis

Abstract: Treatment by sTNFS is a beneficial option for patients with refractory trigeminal pain. Prospective randomised trials are required to systematically evaluate efficacy rates and safety of this low-invasive neurosurgical technique.

Cited by 31 publications

References 20 publications

Neuromodulation and Devices in Trigeminal Neuralgia

Neuromodulation and Devices in Trigeminal Neuralgia

New Results on Brain Stimulation in Chronic Pain

Burst or Conventional Peripheral Nerve Field Stimulation for Treatment of Neuropathic Facial Pain

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