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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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High-Frequency Peripheral Nerve Stimulation for Craniofacial Pain
Philip Finch1,2, Peter Drummond3
1Perth Pain Management Centre, Perth, Washington, Australia, pfinch@iinet.net.au.
Progress in Neurological Surgery
|September 9, 2020
Summary
High-frequency peripheral nerve stimulation, utilizing kilohertz frequencies, offers a promising approach for facial pain management. This advanced neuromodulation technique provides effective pain relief with advantages like lack of paresthesia and improved surgical placement.
Area of Science:
- Neurology
- Biomedical Engineering
Background:
- Neuromodulation for facial pain has evolved since 1962, with traditional peripheral nerve stimulation (PNS) using 1-100 Hz frequencies.
- Recent advancements, particularly the 10-kHz spinal cord stimulation, have spurred interest in applying kilohertz (kHz) frequencies to peripheral neuromodulation.
Purpose of the Study:
- To explore the mechanisms of action for high-frequency peripheral nerve stimulation (HF-PNS) in treating facial pain.
- To present clinical evidence supporting the efficacy of kHz frequency neuromodulation for various facial pain conditions.
Main Methods:
- Review of existing literature on high-frequency electrical stimulation for trigeminal neuralgia and other facial pain syndromes.
- Discussion of the physiological effects of kHz frequency stimulation, including reversible nerve conduction block.
- Presentation of clinical case studies demonstrating successful HF-PNS application.
Main Results:
- High-frequency biphasic stimulation at kHz frequencies induces rapid, reversible conduction block in mammalian nerves.
- While conduction block is a potential mechanism, other factors may contribute to analgesia.
- Clinical examples show successful management of diverse facial pain conditions using HF-PNS.
Conclusions:
- Kilohertz frequency neuromodulation presents distinct advantages over traditional low-frequency stimulation.
- Key benefits include the absence of paresthesias, enhancing patient comfort.
- The ability to position electrodes approximately 1 cm from the target nerve offers significant anatomical and surgical benefits.
