Effect of Repeated Pulsed Radiofrequency for Trigeminal Herpes Zoster Neuralgia: A Retrospective Study

The quality of life for patients suffering from trigeminal herpes zoster neuralgia (TG-HZN) is significantly compromised due to the persistent pain associated with this condition. Pulsed radiofrequency (PRF) has emerged as an effective treatment option. Currently, most patients opt for a single PRF treatment; however, some individuals report inadequate analgesic effects, short durations of pain relief, and overall instability in efficacy. Repeated PRF may enhance therapeutic benefits and improve patient satisfaction.

This retrospective study aimed to evaluate the efficacy of repeated PRF compared to a single PRF in patients with TG-HZN.

We conducted a retrospective analysis of data from 107 TG-HZN patients who underwent CT-guided selective extracranial PRF neurolysis targeting the mandibular branch within the foramen ovale during a one-week hospitalization period. Participants were divided into two groups: single PRF (once PRF, Group S-PRF) and repeated PRF (twice PRF, Group R-PRF). To assess outcomes pre- and post-treatment, we utilized the numeric rating scale (NRS), Pittsburgh Sleep Quality Index (PSQI), and measured the incidence of clinically significant trigeminal postherpetic neuralgia (TG-PHN).

The NRS and PSQI scores of the group R-PRF were significantly lower than those of the group S-PRF at the 1st, 4th, 8th, 12th, and 24th weeks post-treatment (P < 0.05). Additionally, the incidence of clinically meaningful TG-PHN in the group R-PRF was notably lower than that in the group S-PRF at the 12th and 24th weeks post-treatment (P < 0.05).

Repeated pulsed radiofrequency treatments demonstrated substantial efficacy in managing trigeminal herpes zoster neuralgia while also exhibiting superior effectiveness in decreasing the incidence of clinically significant trigeminal postherpetic neuralgia.