Pulsed Radiofrequency of the Trigeminal Ganglion for Treating Postherpetic Neuralgia of the Ophthalmic Branch

Postherpetic neuralgia (PHN) is a painful, long-lasting condition as a consequence of nerve damage resulting from a herpes zoster infection. Although there are many different treatments available to reduce pain duration and severity, PHN is often refractory to them and no single therapy shows an effective cure for all cases of PHN, especially for those involving the ophthalmic branch of the trigeminal nerve. Pulsed radiofrequency (PRF) is a minimally invasive procedure for pain treatment that has been practiced over the past decade. However, its clinical efficacy and safety for treating PHN involving the ophthalmic branch of the trigeminal nerve have not been evaluated. Objective. This study aimed to evaluate the efficacy and safety of PRF for treating PHN involving the ophthalmic branch of the trigeminal ganglion. Study Design. An observational study. Setting. All patients received PRF of the ophthalmic branch of the trigeminal nerve, pain intensity was assessed by a visual analogue scale (VAS), and complications before and after PRF stimulation were noted. Methods. Thirty-two patients with PHN of the ophthalmic branch were treated by PRF of the ophthalmic branch with controlled temperature at 42°C for 8 min. Pain relief, corneal reflex, sleep quality, and satisfaction were assessed for all patients. Results. Thirty out of 32 patients (93.75%) reported significant pain reduction after PRF treatment. Twenty-eight of them (87.5%) were satisfied with their sleep and obtained a pain score lower than 3 following the procedure. Only two patients had a recurrence of the severe burning pain and returned to the hospital for other medical therapies 2 weeks after the PRF procedure. No patient lost the corneal reflex. Limitations. This study is an observational study and a nonprospective trial with a short-term follow-up period. Conclusion. PRF of the trigeminal ganglion of the ophthalmic branch can significantly reduce pain sensation and improve sleep quality and satisfaction.

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Application of Nalbuphine in Trigeminal Ganglion Pulse Radiofrequency Surgery in Patients with Postherpetic Neuralgia

Pain Research and Management ◽

10.1155/2021/6623112 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Song Wen ◽

Qiu-Xia Xiao ◽

Zhao-Qiong Zhu ◽

Li Chen ◽

Ying Li ◽

...

Keyword(s):

Sleep Quality ◽

Trigeminal Ganglion ◽

Postherpetic Neuralgia ◽

Rating Scale ◽

Breakthrough Pain ◽

Nausea And Vomiting ◽

Pulsed Radiofrequency ◽

Ct Guided ◽

Radiofrequency Surgery ◽

Pulse Radiofrequency

This study aimed to explore the application value of nalbuphine in pulsed radiofrequency operation of trigeminal ganglion in patients with postherpetic neuralgia (PHN). Thirty patients with PHN were randomly divided into the nalbuphine (Nalbu) group and ketorolac tromethamine (KT) group and received CT-guided pulsed radiofrequency surgery on trigeminal ganglion. The numeric rating scale (NRS) scores of patients were recorded at preoperative, intraoperative, and postoperative time points, before going to bed, and the next morning after the operation. In addition, the number of breakthrough pain before operation and within 24 hours after operation, the incidence of nausea and vomiting within 24 hours after surgery, and the patient’s sleep quality before and on the day after surgery were evaluated. The outcome data demonstrated that patients treated with nalbuphine had lower NRS scores after the pulse radiofrequency operation during and after the pulse radiofrequency operation compared to those with KT. In addition, nalbuphine effectively decreased the number of breakthrough pain, reduced the occurrence of nausea and vomiting after surgery, and improved the sleep quality. In conclusion, intramuscular injection of nalbuphine 30 min before trigeminal ganglion pulse radiofrequency surgery can be conducive to pain relief and improve the postoperative comfort of patients, providing an effective alternative for the alleviation of PHN in clinic.

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Corrigendum to “Pulsed Radiofrequency of the Trigeminal Ganglion for Treating Postherpetic Neuralgia of the Ophthalmic Branch”

Pain Research and Management ◽

10.1155/2021/9791801 ◽

2021 ◽

Vol 2021 ◽

pp. 1-1

Author(s):

Dong-Yang Liu ◽

Jin-Sheng Chen ◽

Ze-Zang Fang ◽

Shao-Yan Liu ◽

Li Wan

Keyword(s):

Trigeminal Ganglion ◽

Postherpetic Neuralgia ◽

Pulsed Radiofrequency ◽

Ophthalmic Branch

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A Novel Case of Resolved Postherpetic Neuralgia with Subsequent Development of Trigeminal Neuralgia: A Case Report and Review of the Literature

Case Reports in Medicine ◽

10.1155/2013/398513 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Alexander Mason ◽

Kristen Ayres ◽

Sigita Burneikiene ◽

Alan T. Villavicencio ◽

E. Lee Nelson ◽

...

Keyword(s):

Case Report ◽

Herpes Zoster ◽

Trigeminal Neuralgia ◽

Female Patient ◽

Trigeminal Nerve ◽

Postherpetic Neuralgia ◽

Subsequent Development ◽

Review Of The Literature ◽

Trigeminal Pain ◽

Ophthalmic Branch

A 72-year-old female patient is presented, who was diagnosed with herpes zoster along the left ophthalmic branch of the trigeminal nerve with associated cutaneous vesicles. The patient subsequently developed postherpetic neuralgia in the same dermatome, which, after remission, transformed into paroxysmal trigeminal pain. The two different symptom sets, with the former consistent with PHN and the later consistent with trigeminal neuralgia, were unique to our practice and the literature.

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Effective Treatment of Postherpetic Neuralgia at the First Branch of the Trigeminal Nerve by High-Voltage Pulsed Radiofrequency

Frontiers in Neurology ◽

10.3389/fneur.2021.746035 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hongxi Li ◽

Yuanyuan Ding ◽

Yongqiang Zhu ◽

Zhenkai Han ◽

Peng Yao

Keyword(s):

Adverse Events ◽

Effective Treatment ◽

Trigeminal Nerve ◽

High Voltage ◽

Postherpetic Neuralgia ◽

Pulsed Radiofrequency ◽

Treatment Efficiency ◽

Supraorbital Nerve ◽

Sf 36 ◽

Vas Scores

Background: Postherpetic neuralgia (PHN) is one of the most common and serious complications of herpes zoster. PHN of the first branch of the trigeminal nerve is painful and difficult to treat, as no definitive effective treatment is available. The aim of this retrospective study was to observe the efficacy and safety of treatment of PHN of the first branch of the trigeminal nerve with high-voltage pulsed radiofrequency (PRF) of the supraorbital nerve.Methods: Fifty-two patients diagnosed with the PHN of the first branch of the trigeminal nerve at the Department of Pain Management, Shengjing Hospital, China Medical University, between April 2017 and October 2020 were selected. The PRF treatment of the supraorbital nerve was used. The patients were divided into two groups according to the treatment received: group C, conventional PRF group; and group H, high-voltage PRF group. The basic conditions, pain scores, and SF-36 scores of patients before treatment were recorded. Also, intraoperative and postoperative adverse events, visual analog scale (VAS) scores, 36-Item Short Form Health Survey (SF-36) scores at 1 week, 1 month, 3 months, and 6 months of follow-up were recorded. Furthermore, treatment efficiency was followed up at 6 months after treatment.Results: The VAS scores of patients in both groups were significantly lower at all time points after treatment compared with presurgery. VAS scores in group H were lower than those in group C 1, 3, and 6 months after treatment. SF36 scores of patients in group H were better than those in group C 1, 3, and 6 months after treatment. The treatment efficiency at 6 months after treatment was higher in group H than in group C. No serious adverse events occurred in both groups.Conclusion: The efficacy of the high-voltage PRF of the supraorbital nerve in treating the PHN of the first branch of the trigeminal nerve was superior to that of conventional PRF. It was a safe and effective treatment method.

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Efficacy and safety of pulsed radiofrequency modulation of thoracic dorsal root ganglion or intercostal nerve on postherpetic neuralgia in aged patients: a retrospective study

BMC Neurology ◽

10.1186/s12883-021-02286-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xuehua Huang ◽

Yanfeng Ma ◽

Weimin Wang ◽

Yunxiu Guo ◽

Bo Xu ◽

...

Keyword(s):

Dorsal Root Ganglion ◽

Elderly Patients ◽

Postherpetic Neuralgia ◽

Dorsal Root ◽

Adverse Reactions ◽

Intercostal Nerve ◽

Pulsed Radiofrequency ◽

Efficacy And Safety ◽

Aged Patients ◽

Sf 36

Abstract Background Postherpetic neuralgia (PHN) is common in elderly patients and can be alleviated by pulsed radiofrequency (PRF). However, PRF treatments display different efficacy on different nerves. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided PRF modulation on thoracic dorsal root ganglion (DRG) or intercostal nerve (ICN) for PHN in aged patients and to provide a theoretical basis for clinical treatment. Methods We classified aged patients into two groups, DRG group and ICN group, based on the needle tip position. Visual analogue scale (VAS) and concise health status questionnaire (Short-form 36 health/survey questionnaire, SF-36) were used to evaluate the pain intensity and the life quality of the patients before and 2, 4 and 12 weeks after the PRF treatments. We also recorded the adverse reactions during the treatments. Results After the PRF treatment, the scores of VAS and SF-36 (assessing general health perception, social function, emotional role, mental health, and pain) improved significantly in both groups (P < 0.05). The mean VAS score in the DRG group was significantly lower than that in the ICN group 2 weeks after treatment, and remained for 12 weeks. The SF-36 scores in the DRG group were significantly higher than those in the ICN group (P < 0.05). We found a similar incidence of adverse reactions between the two groups (P > 0.05). Conclusions PRF therapy is safe and effective for elderly patients with postherpetic neuralgia. However, PRF treatment in dorsal root ganglion is superior to that in intercostal nerve with improving VAS and SF-36 scores to a greater extent in older patients. Trial registration ChiCTR2100044176.

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