JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Efficacy and safety of combined thermocoagulation radiofrequency and pulse radiofrequency in the treatment of trigeminal neuralgia
Abstract
Aims: The aim of this study was to evaluate the efficacy and safety of radiofrequency thermocoagulation (RFT) combined with pulsed radiofrequency (PRF) of the Gasserian ganglion in patients with V2/V3 trigeminal neuralgia (TN).
Methods: We evaluated 27 patients with V2/3 TN who had undergone combined RFT and PRF of the Gasserian ganglion. Patients were treated with PRF (42°C, 45 V, 20 ms, 120 s), RFT (65°C, 60 s), RFT (70°C, 60 s), and PRF (42°C, 45 V, 20 ms, 120 s), consecutively. Visual analogue scale (VAS) and Barrow Neurological Institute Pain Intensity Scale (BNI) scores were evaluated before and after (1st month, 6th month, and 12th month) the procedure. A BNI score of 1-3 was considered as an effective treatment, while a BNI score of 4 or 5 indicated unsuccessful treatment.
Results: VAS scores were significantly lower than the baseline values in all post-treatment evaluation visits (1st month, 6th month, 12th month) during the 12-month follow-up period (p<0.001). After treatment, 26 patients (96.2%) at 1 month, 25 patients (92.5%) at 6 months, and 20 patients (74%) at 12 months had BNI scores of 1-3. No association was found between improvement in BNI and variables such as age, gender, duration of pain, TN side, affected branch, or pre-treatment VAS scores (p>0.05).
Conclusion: Combined RFT and PRF to the Gasserian ganglion is a safe and effective therapeutic approach in the treatment of TN. However, its efficacy partially decreases after one year.

Keywords : Trigeminal neuralgia, Gasserian ganglion, pulse radiofrequency, radiofrequency thermocoagulation

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1. Arnold M. Headache classification committee of the internationalheadache society (IHS) the international classification ofheadache disorders. Cephalalgia. 2018;38(1):1-211.
2. Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ.2014;348:474.
3. Van Hecke O, Austin SK, Khan RA, Smith B, Torrance N.Neuropathic pain in the general population: a systematic reviewof epidemiological studies. PAIN&reg;. 2014;155(4):654-662.
4. Bharti N, Sujith J, Singla N, Panda NB, Bala I. Radiofrequencythermoablation of the Gasserian ganglion versus the peripheralbranches of the trigeminal nerve for treatment of trigeminalneuralgia: a randomized, control trial. Pain Physician.2019;22(2):147.
5. Van Zundert J, Patijn J, Hartrick C, Lataster A, Huygen F, MekhailN. Evidence-based interventional pain medicine: according toclinical diagnoses. Pain Pract. 2011;11:423-429.
6. Hitchon PW, Holland M, Noeller J, et al. Options in treatingtrigeminal neuralgia: experience with 195 patients. Clin NeurolNeurosurg. 2016;149:166-170.
7. Thapa D, Ahuja V, Dass C, Verma P. Management of refractorytrigeminal neuralgia using extended duration pulsedradiofrequency application. Pain Physician. 2015;18:E433-E435.
8. Vanneste T, Van Lantschoot A, Van Boxem K, Van Zundert J.Pulsed radiofrequency in chronic pain. Curr Opin Anaesthesiol.2017;30(5):577-582.
9. Sridharan K, Sivaramakrishnan G. Interventions for refractorytrigeminal neuralgia: a bayesian mixed treatment comparisonnetwork meta-analysis of randomized controlled clinical trials.Clin Drug Investig. 2017;37(9):819-831.
10. Fang L, Ying S, Tao W, Lan M, Xiaotong Y, Nan J. 3 D CT-GuidedPulsed Radiofrequency Treatment for Trigeminal Neuralgia. PainPract. 2014;14(1):16-21.
11. Fang L, Tao W, Jingjing L, Nan J. Comparison of high-voltage-with standard-voltage pulsed 2015;15(7):595-603.
12. Arici T, Kurcaloglu M, Kilic E, Erhan E. Radiofrequencythermocoagulation combined with pulsed radiofrequency forgasserian ganglion blockage. Agri. 2018;30:179-182.
13. Ren H, Zhao C, Wang X, Shen Y, Meng L, Luo F. The efficacy andsafety of the application of pulsed radiofrequency, combined withlow-temperature continuous radiofrequency, to the Gasserianganglion for the treatment of primary trigeminal neuralgia: studyprotocol for a prospective, open-label, parall. Pain Physician.2021;24(1):89.
14. Elawamy A, Abdalla EEM, Shehata GA. Effects of pulsed versusconventional versus combined radiofrequency for the treatmentof trigeminal neuralgia: a prospective study. Pain Physician.2017;20(6):E873.
15. Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlledradiofrequency trigeminal rhizotomy for the treatment ofidiopathic trigeminal neuralgia: 25-year experience with 1600patients. Neurosurg. 2001;48(3):524-534.
16. Gunduz HB, Cevik OM, Asilturk M, et al. PercutaneousRadiofrequency Thermocoagulation in Trigeminal Neuralgia:Analysis of Early and Late Outcomes of 156 Cases and 209Interventions. J Korean Neurosurg Soc. 2021;64(5):827-836.
17. Zhou X, Liu Y, Yue Z, Luan D, Zhang H, Han J. Comparisonof nerve combing and percutaneous radiofrequencythermocoagulation in the treatment for idiopathic trigeminalneuralgia. Braz J Otorhinolaryngol. 2016;82:574-579.
18. Tang Y-Z, Jin D, Bian J-J, Li X-Y, Lai G-H, Ni J-X. Long-termoutcome of computed tomography-guided percutaneousradiofrequency Thermocoagulation for classic trigeminalneuralgia patients older than 70 years. J Craniofac Surg.2014;25(4):1292-1295.
19. Wu H, Zhou J, Chen J, Gu Y, Shi L, Ni H. Therapeutic efficacy andsafety of radiofrequency ablation for the treatment of trigeminalneuralgia: a systematic review and meta-analysis. J Pain Res.2019;12:423.
20. Mathews ES, Scrivani SJ. Percutaneous stereotacticradiofrequency thermal rhizotomy for the treatment of trigeminalneuralgia. Mt Sinai J Med. 2000;67(4):288-299.
21. Cahana A, Van Zundert J, Macrea L, Van Kleef M, Sluijter M.Pulsed radiofrequency: current clinical and biological literatureavailable. Pain Med. 2006;7(5):411-423.
22. Rehman S, Khan M, Hussain R, Jamshed A. Pulsedradiofrequency modulation for lingual neuralgia. Br J OralMaxillofac Surg. 2012;50(1):e4-e5.
23. Cosman Jr ER, Cosman Sr ER. Electric and thermal fieldeffects in tissue around radiofrequency electrodes. Pain Med.2005;6(6):405-424.
24. Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7(5):396-407.
25. Chua NHL, Halim W, Beems T, Vissers KC. Pulsedradiofrequency treatment for trigeminal neuralgia. Anesth PainMed. 2012;1(4):257.
26. Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, DisciR. Comparison of pulsed radiofrequency with conventionalradiofrequency in the treatment of idiopathic trigeminalneuralgia. Eur J Pain. 2007;11(3):309-313.
27. Ali Eissa AA, Reyad RM, Saleh EG, El-Saman A. The efficacyand safety of combined pulsed and conventional radiofrequencytreatment of refractory cases of idiopathic trigeminal neuralgia: aretrospective study. J Anesth. 2015;29(5):728-733.
28. Ding Y, Li H, Hong T, Zhu Y, Yao P, Zhou G. Combinationof pulsed radiofrequency with continuous radiofrequencythermocoagulation at low temperature improves efficacy andsafety in V2/V3 primary trigeminal neuralgia. Pain Physician.2018;21(5):E545.
29. Abdel-Rahman KA, Elawamy AM, Mostafa MF, et al.Combined pulsed and thermal radiofrequency versus thermalradiofrequency alone in the treatment of recurrent trigeminalneuralgia after microvascular decompression: a double blindedcomparative study. Eur J Pain. 2020;24(2):338-345.
30. Tanaka N, Yamaga M, Tateyama S, Uno T, Tsuneyoshi I, TakasakiM. The effect of pulsed radiofrequency current on mechanicalallodynia induced with resiniferatoxin in rats. Anesth Analg.2010;111(3):784-790.
31. Zhao W, Wang Q, He M, Yang L, Wu B, Ni J. Radiofrequencythermocoagulation combined with pulsed radiofrequency helpsrelieve postoperative complications of trigeminal neuralgia.Genet Mol Res. 2015;14(3):7616-7623.
Article available in :
Volume 4, Issue 4, 2023
Page : 252-257
https://doi.org/10.47582/jompac.1303163
Article Information
Received : 27 May 2023
Accepted : 01 Tem 2023
Published : 30 Ağu 2023
Corresponding Author :

Samet Sancar Kaya: Department of Algology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey

[email protected]
Citation : Kaya SS, Çelik Ş, Akçaboy EY. Efficacy and safety of combined thermocoagulation radiofrequency and pulse radiofrequency in the treatment of trigeminal neuralgia. J Med Palliat Care. 2023;4(4):252-257

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