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Radiofrequency rhizotomy for multiple sclerosis-related trigeminal neuralgia: a systematic review and meta-analysis
Bardia Hajikarimloo1, Salem M Tos2, Ibrahim Mohammadzadeh3
1Department of Neurological Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. bardii47@yahoo.com.
Background:
Radiofrequency rhizotomy (RFR) is one of the primary therapeutic options for managing patients suffering from multiple sclerosis-related trigeminal neuralgia (MS-TN). Given the increasing use of RFR for MS-TN and the absence of consensus on its efficacy, we aimed to assess the clinical application of RFR in this patient population.
Methods:
On April 7, 2025, we conducted a systematic literature search. Studies that evaluated the pain-related outcomes of RFR in MS-TN patients were included.
Results:
Fifteen studies involving 278 MS-TN patients who received RFR were included. The meta-analysis revealed a pooled pain-free rate and adequate pain-relief rate of 78% (95% CI: 58%-93%) and 96% (95% CI: 89%-100%) at the initial follow-up. In addition, the meta-analysis demonstrated a pooled pain-free rate and adequate pain-relief rate of 64% (95% CI: 25%-95%) and 86% (95% CI: 63%-99%), respectively, at the last follow-up. The pooled complication rate in our study was 9% (95% CI: 1%-22%).
Conclusions:
RFR is associated with substantial immediate pain relief rates, reasonable complication rates, and favorable long-term pain-related outcomes. However, the long-term outcomes show considerable variability and should be interpreted cautiously. RFR can be considered one of the main therapeutic options for patients suffering from MS-TN, where the pain has limited their daily performance.
