Nasher Abdulghani A, Salah Khaled, Al-Zubaidi Naji A, Al-Haidari Sami A
Department of Neurology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Department of Neurology, Faculty of Medicine, 21 st September University for Medical and Applied Sciences, Sana'a, Yemen.
BMC Neurol. 2025 Jul 1;25(1):268. doi: 10.1186/s12883-025-04269-3.
Trigeminal neuralgia (TN) is a severely painful condition that is challenging to treat effectively. For patients who do not respond well to oral medications, percutaneous radiofrequency thermocoagulation (PRT) has emerged as a safe and minimally invasive procedure for treating TN. This study aimed to assess the safety and effectiveness of PRT in treating elderly patients with ITN.
A prospective cohort study was conducted among 134 elderly patients with ITN subjected to PRT at the Pioneer Medical Center for Neurosurgery and Pain Management in Sana'a city, Yemen, from September 2022 to October 2024. PRT was performed by foramen ovale puncture, and repeat PRT was conducted for all patients with recurrent pain. The Barrow Neurological Institute (BNI) pain intensity scale was used to assess the degree of pain after PRT. The outcome was considered successful if the patient's BNI score decreased to I-IIIb or failed if a patient's BNI pain score was IV or V. Recurrence of pain and complications were also recorded. Data about the safety and effectiveness of PRT were then summarized using descriptive statistics.
PRT was successful in 125 of 134 patients (93.3%), with 95 patients (71.4%) achieving complete pain relief (BNI score I) and 30 patients (22.4%) achieving adequate pain control (BNI scores II-IIIb). Pain recurrence was observed in 27 patients (20.1%) within two years, and repeat PRT was successful in all recurrent cases, with 19 patients (70.4%) achieving complete pain relief. Complications were minimal, with intrabuccal hematoma being the most common (4.5%) and dysesthesia the least common (1.5%).
PRT is a highly effective and safe treatment for elderly patients with ITN in Yemen, achieving an immediate success rate of over 90% in pain relief. While pain recurrence is a notable concern, repeat PRT proves to be a reliable solution for managing recurrent pain. PRT is associated with a low rate of mild and transient complications, but long-term monitoring and follow-up for recurrence and complications are essential to optimize outcomes.
三叉神经痛（TN）是一种疼痛剧烈的疾病，有效治疗具有挑战性。对于口服药物反应不佳的患者，经皮射频热凝术（PRT）已成为一种治疗TN的安全且微创的方法。本研究旨在评估PRT治疗老年特发性三叉神经痛（ITN）患者的安全性和有效性。
2022年9月至2024年10月，在也门萨那市先锋神经外科和疼痛管理医疗中心，对134例接受PRT治疗的老年ITN患者进行了一项前瞻性队列研究。PRT通过卵圆孔穿刺进行，所有复发性疼痛患者均进行了重复PRT。采用巴罗神经学研究所（BNI）疼痛强度量表评估PRT后的疼痛程度。如果患者的BNI评分降至I - IIIb，则结果视为成功；如果患者的BNI疼痛评分为IV或V，则视为失败。还记录了疼痛复发和并发症情况。然后使用描述性统计方法总结PRT安全性和有效性的数据。
134例患者中有125例（93.3%）PRT治疗成功，其中95例（71.4%）疼痛完全缓解（BNI评分I），30例（22.4%）疼痛得到充分控制（BNI评分II - IIIb）。27例患者（20.1%）在两年内出现疼痛复发，所有复发病例重复PRT均成功，其中19例（70.4%）疼痛完全缓解。并发症极少，颊内血肿最常见（4.5%），感觉异常最不常见（1.5%）。
PRT是也门老年ITN患者的一种高效且安全的治疗方法，疼痛缓解的即刻成功率超过90%。虽然疼痛复发是一个值得关注的问题，但重复PRT被证明是处理复发性疼痛的可靠解决方案。PRT相关的轻度和短暂并发症发生率较低，但对复发和并发症进行长期监测和随访对于优化治疗效果至关重要。
