Klein Johann, Sandi-Gahun Sahr, Schackert Gabriele, Juratli Tareq A
Department of Neurosurgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Department of Neurosurgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Cephalalgia. 2016 Apr;36(5):445-53. doi: 10.1177/0333102415597526. Epub 2015 Jul 24.
Peripheral nerve field stimulation (PNFS) is a promising modality for treatment of intractable facial pain. However, evidence is sparse. We are therefore presenting our experience with this technique in a small patient cohort.
Records of 10 patients (five men, five women) with intractable facial pain who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation were retrospectively analyzed. Patients' data, including pain location, etiology, duration, previous treatments, long-term effects and complications, were evaluated.
Four patients suffered from recurrent classical trigeminal neuralgia, one had classical trigeminal neuralgia and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, one from post-herpetic neuropathy, one from trigeminal neuropathy following radiation therapy and one from persistent idiopathic facial pain. Average patient age was 74.2 years (range 57-87), and average symptom duration was 10.6 years (range 2-17). Eight patients proceeded to implantation after successful trial. Average follow-up after implantation was 11.3 months (range 5-28). Using the visual analog scale, average pain intensity was 9.3 (range 7-10) preoperatively and 0.75 (range 0-3) postoperatively. Six patients reported absence of pain with stimulation; two had only slight constant pain without attacks.
PNFS may be an effective treatment for refractory facial pain and yields high patient satisfaction.
周围神经场刺激（PNFS）是一种治疗顽固性面部疼痛的有前景的方法。然而，相关证据较少。因此，我们在此介绍我们在一小群患者中应用该技术的经验。
回顾性分析了10例顽固性面部疼痛患者（5名男性，5名女性）的记录，这些患者接受了三叉神经场刺激的一个或多个皮下电极植入。评估了患者的数据，包括疼痛部位、病因、病程、既往治疗、长期效果和并发症。
4例患者患有复发性经典三叉神经痛，1例患有经典三叉神经痛且因医学原因不适合进行微血管减压术。2例患者患有继发于多发性硬化的三叉神经病变，1例患有疱疹后神经病变，1例患有放疗后三叉神经病变，1例患有持续性特发性面部疼痛。患者平均年龄为74.2岁（范围57 - 87岁），平均症状持续时间为10.6年（范围2 - 17年）。8例患者在试验成功后进行了植入。植入后的平均随访时间为11.3个月（范围5 - 28个月）。使用视觉模拟量表，术前平均疼痛强度为9.3（范围7 - 10），术后为0.75（范围0 - 3）。6例患者报告刺激时无疼痛；2例仅有轻微持续性疼痛，无发作。
PNFS可能是治疗难治性面部疼痛的有效方法，并能使患者满意度较高。
