AlHabil Yazan, Al-Sayed Khulood, Salameh Ashraf
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 00970, Palestine.
Director of Quality, Patient Safety, Infection Control, and Governance Department, Primary Health Care, Palestinian Ministry of Health, Ramallah, 00970, Palestine.
BMC Neurol. 2025 Jan 8;25(1):13. doi: 10.1186/s12883-024-04014-2.
Trigeminal neuralgia (TN) is a prevalent and debilitating craniofacial pain disorder characterized by severe, unilateral, shock-like pain. Standard treatments include anti-epileptic drugs and surgical interventions, but many patients experience limited relief or adverse effects. Non-invasive therapies, such as transcutaneous electrical nerve stimulation (TENS), have emerged as alternative options. This systematic review and meta-analysis aimed to evaluate the efficacy of TENS in managing primary trigeminal neuralgia.
A comprehensive search of PubMed, Cochrane Library, and Google Scholar was conducted, yielding 89 papers. Following selection criteria, five clinical trials involving 101 patients with primary TN and TENS treatment were included. Data on pain severity, TENS parameters, and outcomes were extracted. Statistical analysis was performed using RevMan software, with outcomes assessed using Visual Analogue Scale (VAS) scores before and after TENS treatment.
Pre-treatment VAS scores averaged 8.75 ± 0.18, indicating severe pain. Post-treatment, the mean VAS score significantly decreased to 1.17 ± 0.55, demonstrating substantial pain relief. The meta-analysis revealed a mean difference of 7.49 (95% CI: 7.05 to 7.93) in VAS scores, with a p-value < 0.05, indicating statistically significant pain reduction. Heterogeneity among studies was moderate (I = 57%). Complications were infrequently reported, with one study noting paresthesia in a small number of patients.
TENS appears to be an effective and safe intervention for reducing pain in patients with primary trigeminal neuralgia. Despite variability in treatment protocols and follow-up periods, the overall evidence supports TENS as a viable option for managing TN pain. Future research should focus on standardizing TENS protocols and evaluating long-term efficacy and safety.
三叉神经痛(TN)是一种常见且使人衰弱的颅面部疼痛疾病,其特征为严重的单侧电击样疼痛。标准治疗方法包括抗癫痫药物和手术干预,但许多患者缓解效果有限或出现不良反应。非侵入性疗法,如经皮电刺激神经疗法(TENS),已成为替代选择。本系统评价和荟萃分析旨在评估TENS治疗原发性三叉神经痛的疗效。
全面检索了PubMed、Cochrane图书馆和谷歌学术,共获得89篇论文。根据选择标准,纳入了5项涉及101例原发性TN患者并接受TENS治疗的临床试验。提取了疼痛严重程度、TENS参数和结局的数据。使用RevMan软件进行统计分析,结局采用TENS治疗前后的视觉模拟量表(VAS)评分进行评估。
治疗前VAS评分平均为8.75±0.18,表明疼痛严重。治疗后,平均VAS评分显著降至1.17±0.55,显示疼痛得到大幅缓解。荟萃分析显示VAS评分的平均差值为7.49(95%CI:7.05至7.93),p值<0.05,表明疼痛减轻具有统计学意义。研究间的异质性为中度(I=57%)。并发症报告较少,一项研究指出少数患者出现感觉异常。
TENS似乎是减轻原发性三叉神经痛患者疼痛的一种有效且安全的干预措施。尽管治疗方案和随访期存在差异,但总体证据支持TENS作为管理TN疼痛的可行选择。未来的研究应侧重于规范TENS方案,并评估其长期疗效和安全性。