Niu Jiejie, Wang Chenhui, Wang Xing, Lu Guijun
Department of Pain Management, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2024 Jul 17;15:1435272. doi: 10.3389/fneur.2024.1435272. eCollection 2024.
Gasserian ganglion stimulation (GGS) is a neuromodulation technique that has been extensively applied in treating postherpetic trigeminal neuralgia. However, permanent implantation of GGS was preferred in most treatment approaches. Few studies have investigated temporary GGS for the treatment of acute/subacute herpetic trigeminal neuralgia. Moreover, previous research has reported lead dislocation when utilizing traditional electrodes, which was associated with poor pain relief. In GGS research, preventing the accidental displacement of lead following implantation has consistently been a primary objective.
We report a case of a 70-year-old woman with subacute herpetic trigeminal neuralgia who underwent temporary GGS for 14 days utilizing a sacral neuromodulation (SNM) quadripolar-tined lead. Computed tomography-guided percutaneous foramen ovale (FO) puncture and temporary SNM electrode implantation were performed during the surgery. A telephone interview was conducted to record a 12-month follow-up.
At admission, zoster-related trigeminal pain severity was assessed to be 9/10 on the visual analog scale (VAS). After a 14-day GGS treatment, the pain assessed on the VAS score reduced to 1/10 at discharge but increased to 4/10 at the 12-month follow-up after surgery. Additionally, the anxiety level improved from 58 points to 35 points on the Self-Rating Anxiety Scale (SAS), and the depression level improved from 62 points to 40 points on the Self-Rating Depression Scale (SDS). The Physical Component Summary score of the 12-item Short-Form Health Survey (SF-12) increased from 33.9 to 47.0, and the Mental Component Summary (MCS) score of the SF-12 increased from 27.4 to 41.9.
Temporary GGS might be a potentially effective treatment for subacute herpetic trigeminal neuralgia, and an SNM electrode might be a good choice for reducing the risk of dislocation.
半月神经节刺激术（GGS）是一种神经调节技术，已广泛应用于治疗带状疱疹后三叉神经痛。然而，在大多数治疗方法中，更倾向于永久性植入GGS。很少有研究探讨临时性GGS治疗急性/亚急性带状疱疹性三叉神经痛。此外，先前的研究报道，使用传统电极时会出现导线移位，这与疼痛缓解不佳有关。在GGS研究中，防止植入后导线意外移位一直是主要目标。
我们报告一例70岁亚急性带状疱疹性三叉神经痛女性患者，使用骶神经调节（SNM）四极倒刺导线进行了为期14天的临时性GGS治疗。手术期间进行了计算机断层扫描引导下经皮卵圆孔（FO）穿刺和临时性SNM电极植入。进行了电话随访以记录12个月的随访情况。
入院时，带状疱疹相关三叉神经痛严重程度在视觉模拟量表（VAS）上评估为9/10。经过14天的GGS治疗后，出院时VAS评分评估的疼痛降至1/10，但术后12个月随访时升至4/10。此外，焦虑水平在自评焦虑量表（SAS）上从58分改善至35分，抑郁水平在自评抑郁量表（SDS）上从62分改善至40分。12项简明健康调查问卷（SF-12）的身体成分总结评分从33.9提高至47.0，SF-12的精神成分总结（MCS）评分从27.4提高至41.9。
临时性GGS可能是亚急性带状疱疹性三叉神经痛的一种潜在有效治疗方法，SNM电极可能是降低移位风险的一个良好选择。
