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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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Peripheral nerve field stimulation in medically refractory trigeminal neuralgia attributed to multiple sclerosis
Johann Klein1,2, Timo Siepmann3,2, Gabriele Schackert1
11Department of Neurosurgery, University Hospital Carl Gustav Carus.
Journal of Neurosurgery
|March 21, 2020
Summary
Peripheral nerve field stimulation (PNFS) may offer long-term pain relief for some patients with multiple sclerosis (MS)-related trigeminal neuralgia. While effective for some, PNFS treatment outcomes vary, with potential for long-term benefit in select individuals.
Area of Science:
- Neurosurgery
- Neurology
- Pain Management
Background:
- Refractory trigeminal neuralgia (TN) in multiple sclerosis (MS) poses significant challenges.
- Peripheral nerve field stimulation (PNFS) has emerged as a potential treatment option.
Purpose of the Study:
- To evaluate the long-term efficacy of PNFS in patients with MS-attributed TN.
- To assess changes in pain severity and identify factors influencing treatment outcomes.
Main Methods:
- Prospective data collection from patients with MS-related TN undergoing PNFS.
- Pain severity assessed using the Barrow Neurological Institute (BNI) Scale.
- Regular follow-up evaluations for at least two years post-implantation.
Main Results:
- Seven of eight patients proceeded to permanent PNFS implantation.
- Median follow-up of 33 months showed a decrease in BNI pain scores (p=0.054).
- Four patients experienced sustained pain relief, while three had treatment failure after initial success. One infection occurred.
Conclusions:
- PNFS demonstrates a possibly beneficial long-term effect for some patients with refractory MS-related TN.
- Treatment outcomes are variable, highlighting the need for individualized patient selection.
- Further research is warranted to optimize PNFS for TN management.
