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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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Case Series: Deep Brain Stimulation for Facial Pain
Alon Kashanian1, Jasmine A T DiCesare1, Pratik Rohatgi1
1Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
Operative Neurosurgery (Hagerstown, Md.)
|June 17, 2020
Summary
Deep brain stimulation (DBS) shows a trend toward improving facial pain, particularly for post-traumatic cases. While not all patients responded, most would undergo the procedure again.
Area of Science:
- Neurosurgery
- Pain Management
- Neuromodulation
Background:
- Deep brain stimulation (DBS) has a long history in treating chronic pain.
- Its application for specific facial pain indications is limited by insufficient efficacy data.
Purpose of the Study:
- To evaluate the outcomes of DBS in nine patients with facial pain.
- To compare treatment efficacy across different facial pain etiologies.
Main Methods:
- Retrospective review of nine patients with facial pain treated with DBS.
- Targeting of the ventral posteromedial nucleus of the thalamus and periventricular gray.
- Assessment of pain reduction using the Visual Analog Scale (VAS) and patient willingness to repeat the procedure.
Main Results:
- Seven patients with sufficient follow-up showed an average VAS decrease from 9.4 to 6.1.
- The most significant pain reduction was observed in post-traumatic facial pain (55% decrease).
- Complications occurred in 38% of implanted patients, and only 29% met responder criteria, though 100% of those asked would repeat the procedure.
Conclusions:
- DBS demonstrates a potential for pain reduction in facial pain patients.
- Post-traumatic facial pain appears to respond most favorably to DBS.
- Despite complications and varied response rates, patient willingness to repeat DBS suggests perceived benefit.
