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Updated: Apr 16, 2026
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Published on: March 8, 2015
Reviving Hope: Overcoming Deep Brain Stimulation Failure With Partial Cranial Nerve Radiofrequency Ablation in
Xue Li1, Min Yan1,2,3, Bing Huang1,4
1Pain Management Center, Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Introduction:
Deep brain stimulation (DBS) is a standard treatment for refractory primary Meige syndrome (PMS), yet 30%-50% of patients experience suboptimal outcomes. Management strategies for these "DBS failures" remain undefined. This study evaluates the efficacy of partial cranial nerve radiofrequency ablation (RFA) as a salvage therapy for this challenging population.
Methods:
We report a retrospective series of three PMS patients classified as "DBS non-responders" based on clinical refractory status or ineligibility for lead revision. Patients underwent imaging-guided partial RFA of the facial nerve (for blepharospasm) and/or mandibular nerve (for oromandibular dystonia). The procedure utilized a graded thermal protocol, titrated strictly to a mild, controlled functional impairment clinical endpoints.
Results:
Immediate symptom remission was achieved in all cases. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) Movement subscores decreased significantly (e.g., from 9 to 0 in Case 1, and 14 to 0.5 in Case 2). Procedural sequelae, including mild facial paralysis and masticatory weakness, were transient and resolved within 3-6 months. One patient experienced symptom recurrence at 14 months, which was successfully managed via repeat RFA.
Conclusion:
Partial cranial nerve RFA is a feasible, effective, and repeatable salvage therapy for PMS following DBS failure. By targeting the peripheral conduction pathway, it offers a distinct mechanism of action and a practical alternative when central neuromodulation proves insufficient. Future studies with larger cohorts are warranted to validate these preliminary findings.
