the Value of Sensory Index in Trigeminal Neuralgia
Pain, Chronic
About this trial
This is an interventional treatment trial for Pain, Chronic
Eligibility Criteria
Inclusion Criteria:
- Patients with trigeminal neuralgia, diagnosed in accordance with the International Headache Society (7) and with a visual analogue score (VAS) for pain of at least 7 or more for a minimum of 3 months before the intervention .
- Patients on a stable analgesic regimen for 2 weeks (consisting of at least two analgesics, including anticonvulsants) before the intervention .
- Patients examined by use of MRI/A of the brain to exclude secondary neuralgia.
Exclusion Criteria:
- Patients with severe mental or psychiatric disorders
- Patients with history of drug abuse, high intracranial tension and history of MVD, SGK, balloon compression, RF treatment, or glycerol injection
- The possibility of vascular loop compression and other causes of TN
Sites / Locations
- National Cancer Institute
Arms of the Study
Arm 1
Other
combined conventional and pulsed radiofrequency of trigeminal nerve nucleus
The technique of the CCPRF is described as follows; the classic Hartle technique is used to reach the Gasserian ganglion Sensory stimulation with the RF equipment is conducted and parathesia of the affected branch is achieved at 0.1-0.2 V (50 Hz), keeping in mind that the mandibular part of the Gasserian ganglion is ventrolateral and the ophthalmic rootlets are postrolateral. Motor pre-stimulation (2 Hz) is achieved with masseter contraction at 0.1-0.3 V . After sensory and motor stimulation, RF therapy is conducted by use of the RF generator , in the sequence: Conventional RF 1st lesion at 60 °C for 60 s then 2nd lesion at 65°C for 60 seconds then 3rd lesion at 70°C for 60 seconds Finally, PRF is applied for 360 second repeated at 45 V, with a pulse width of 10 ms and a pulse frequency of 4 Hz. The cut-off needle tip temperature is set at 42 °C. Before withdrawal of needle 1 cc xylocaine 1% + 0.5 cc dexamethasone 4mg to be given .