Repetitive percutaneous radiofrequency thermocoagulation for persistent idiopathic facial pain and central neuropathic pain attributed to multiple sclerosis-a retrospective monocentric analysis
| Autor: | Walter Stummer, Lars Lemcke, Bilal Al Barim, Michael Schwake, Stephanie Schipmann |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Percutaneous Multiple Sclerosis Radio Waves medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Radiofrequency thermocoagulation Facial Pain medicine Electrocoagulation Humans Pain Management Atypical trigeminal neuralgia Aged Retrospective Studies Aged 80 and over business.industry Chronic pain Middle Aged Trigeminal Neuralgia medicine.disease Surgery Treatment Outcome Trigeminal Ganglion Neuropathic pain Neuralgia Female Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery Atypical facial pain |
| Zdroj: | Acta neurochirurgica. 162(11) |
| ISSN: | 0942-0940 |
| Popis: | Persistent idiopathic facial pain (PIFP) is a debilitating chronic pain condition with pain radiating to trigeminal dermatomes. Typically, there are no pathological findings that can be identified during workup and therapy is symptomatic. Facial pain is common in patients with multiple sclerosis (central neuropathic pain attributed to MS). Our aim was to evaluate the effectiveness of percutaneous radiofrequency thermocoagulation (PRTC) of the gasserian ganglion and the duration of pain relief, as well as the identification of factors associated with its outcome. Data on all the above-mentioned patients that have been treated with PRTC between 2009 and 2019 were included into the study. The outcome was assessed with a six-tiered score from 1 (complete remission) to 6 (no benefit). Univariate and multivariate analyses were performed in order to obtain factors associated with the outcome. A total of 52 patients were included. The total number of procedures performed was 114. 61.5% of patients who experienced temporary pain relief that lasted for a median of 60 days (range 3–1490 days). In patients with recurrence, the fraction of successful interventions was higher, and also transient, with successful pain amelioration in over 80% of patients. Successful responses to PRTC were observed in 27.9% after 1 year, 19.4% after 2 years, and 8.3% after 3 years. The only independent variable predicting pain relief was a repeat intervention with a history of ≥ 2 interventions (OR: 4.36, 95%-CI: 1.34–14.34, p = 0.015). No severe complications occurred. Our data showed good and immediate pain relief after PRTC in the majority of our patients. PRTC is a low-risk procedure that can be discussed as an option in case of failure of medical treatment even in critically ill patients and can be repeated with good results when necessary. Long-term pain amelioration, even with repeated procedures, was not possible and no patient was permanently cured. |
| Databáze: | OpenAIRE |
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