Dept. of Pain Medicine, First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Dept. of Pain Medicine, Ganzhou People's Hospital, Ganzhou, China.
Pain Physician. 2024 Sep;27(7):E775-E784.
Trigeminal herpetic neuralgia (THN) presents with severe pain hyperalgesia and is a high-risk factor for postherpetic neuralgia (PHN). The current clinical treatments for THN are unsatisfactory, and new treatments are desperately required.
This pilot study aimed to evaluate the efficacy of short-term trigeminal ganglion stimulation in treating patients with multi-branch THN.
A prospective pilot study.
Multi-center study in 3 academic hospitals.
From July 2021 to October 2022, we enrolled 20 patients with multi-branch THN who received short-term trigeminal ganglion stimulation under general anesthesia from 3 hospitals. All patients completed a 12-month follow-up. The visual analog scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess patients' pain and quality of sleep. The Barrow Neurological Institute (BNI) score was used to determine the global outcome of pain relief, and complications were recorded.
Significant and sustained pain relief and sleep improvement were achieved by all the patients who underwent trigeminal ganglion electrode stimulation in the present study. Respective BNI scores of 80% and 85% at 3 and 12 months after surgery were considered good. There were no other serious complications except for 2 patients' experiences of transient trigeminal cardiac reflex during the surgery and transient numbness deterioration in one patient's V3 sensory area.
The present study is a pilot study. We expect prospective multi-center, large-sample studies in the future.
Short-term trigeminal ganglion stimulation can be used safely and effectively to treat patients with multi-branch THN and significantly reduce the occurrence of PHN.
三叉神经疱疹性神经痛（trigeminal herpetic neuralgia，THN）表现为严重疼痛、痛觉过敏，是发生疱疹后神经痛（postherpetic neuralgia，PHN）的高危因素。目前，THN 的临床治疗效果并不令人满意，急需新的治疗方法。
本研究旨在评估短期三叉神经节刺激治疗多支三叉神经痛的疗效。
前瞻性试点研究。
3 家学术医院的多中心研究。
2021 年 7 月至 2022 年 10 月，我们从 3 家医院招募了 20 例接受全身麻醉下短期三叉神经节刺激治疗的多支三叉神经痛患者。所有患者均完成了 12 个月的随访。采用视觉模拟评分（visual analog scale，VAS）和匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）评估患者的疼痛和睡眠质量。采用巴罗神经研究所（Barrow Neurological Institute，BNI）评分评估疼痛缓解的总体疗效，并记录并发症。
本研究中接受三叉神经节电极刺激的所有患者均获得显著且持续的疼痛缓解和睡眠改善。术后 3 个月和 12 个月的 BNI 评分分别为 80%和 85%，被认为疗效良好。除 2 例患者在手术中出现短暂的三叉心脏反射和 1 例患者 V3 感觉区出现短暂麻木恶化外，无其他严重并发症。
本研究为试点研究，我们期望未来开展前瞻性、多中心、大样本研究。
短期三叉神经节刺激可安全有效地治疗多支三叉神经痛患者，显著降低 PHN 的发生。
