Abstract

CASTRO, M. et al. Pulsed radiofrequency in the management of trigeminal essential neuralgia: Is a valid alternative to the conventional radiofrequency?. Rev. Soc. Esp. Dolor [online]. 2008, vol.15, n.3, pp.138-144. ISSN 1134-8046.

Objectives. To demónstrate the effectiveness and safety of pulsed radiofrequency in the treatment of the essential trigeminal neuralgia and to compare it with the conventional technique. Matherial and Methods. This is a prospective observational study of 32 patients diagnosed of essential trigeminal neuralgia in which a total of 44 radiofrequencies were applied to the Gasserian ganglion. The radiophrequencies were performed in operating room under X-ray control with a Neurotherm generator, a 22G SMK needles, a sensitive stimulation to 50 Hz up to noticing parestesia with 0,3-0,5 V and motor to 2 Hz without contraction of the masseter muscle finds except if third branch was stimulated. 28 pulsed radiophrequencies (RFP) and 16 conventional (RFC) were carried out. The RFP were carried out at a temperature 40 ºC during 120 seconds whereas the RFC were performed at 80 ºC during 60 seconds. The efficiency of the treatment was based on control of the pain according to the EVA scale at 30, 90, and 180 days and by means of Lattinen's test before and at the end of the study. All the patients were asked regarding the possible side effects of the treatment. Results. 44 procedures were realized. 60% of the patients were males and 40% women. The mean age was 68.32 years. Both groups were comparable as for previous pathology and personal precedents. In 4.5% of the patients, the first branch was affected, in 31.8% the second branch, in 36.4% the third branch, in 13.6% the first and second branch, and finally in 13.6% the second and third branch. The patients received RFP in 63,6% of the cases and RFC in 36.4 %. In the RFP group the evolution of the VAS was as followed: VAS 0: 8; VAS 1: 3.4; VAS 3: 2.5 and VAS 6: 2. and the Lattinen Índex, LO: 16.9 and L6: 6. In the RFC group: VAS 0: 7.9; VAS 1: 3.25; VAS 3: 2 and VAS 6: 2. Lattinen índex: LO: 16.125 and L6: 5. There were no statistically significant differences in the reduction of VAS and Lattinen. In the group of RFP it was necessary repeat the technique in 28,57% of the cases and in the group of RFC in 25% of the same ones. In none of two groups were observed neither complications derived from the technique ñor side effects. Conclusions. The RFP of the Gasser's ganglion appears as an effective and safe alternative treatment to the RFC in the management of the essential trigeminal neuralgia.

Keywords : Trigeminal neuralgia; pulsed radiofrequency.

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