the Value of Sensory Index in Trigeminal Neuralgia
Condition: Pain, Chronic
MeSH terms: Trigeminal Neuralgia; Neuralgia; Chronic Pain
Study type: Interventional

Summary: 
      Interventional therapies for Trigeminal Neuralgia are of variable efficacy and safety, and
      have different results for different periods of time before the recurrence of symptoms.
      Interventional therapy for TN is either destructive with trigeminal nerve sensory function
      destroyed intentionally or non-destructive with decompression of the trigeminal nerve and
      preservation of its regular function. The most common procedures in treating TN pain are the
      use of radiofrequency (RF). the aim of this study is to assess the possible value of motor
      index as a prediction of success of radiofrequency lesioning of the Gasserian ganglion during
      treatment of trigeminal neuralgia.
    

Detailed description: 
      Trigeminal neuralgia (TN) is defined by the International Headache Society (IHS) as
      "unilateral disorder characterized by brief electric shock-like pains, abrupt in onset and
      termination, and limited to the distribution of one or more divisions of the trigeminal
      nerve". It is considered the worst type of facial pain and described as intense, sharp,
      stabbing, and shooting like electric shock pain. It can be triggered by touch, chewing,
      laughing, shaving or face wash .

      The IHS suggests a classification of TN as either classic (essential or idiopathic) TN (CTN)
      or symptomatic TN (STN; pain indistinguishable from that of CTN, but caused by a demonstrable
      structural lesion other than vascular compression).Treatment of TN is conservative, surgical
      or interventional. Pharmacotherapy with carbamazepine is tried early in cases of TN but has
      many side effects .Other medications can be used in the treatment of TN, include
      oxycarbazepine, gabapentin, pregabalin, baclofen, valproate, clonazepam, phenytoin, and
      lamotrigime .

      The most clinically appropriate treatment includes surgical microvascular decompression
      (MVD), stereotactic radiation therapy, gamma knife (SGK), percutaneous balloon decompression,
      percutaneous glycerol rhizolysis, percutaneous radiofrequency (RF) of the Gasserian ganglion
      (GG), and GG stimulation and neuromodulation. Interventional therapies for TN are of variable
      efficacy and safety, and have different results for different periods of time before the
      recurrence of symptoms. Interventional therapy for TN is either destructive with trigeminal
      nerve sensory function destroyed intentionally or non-destructive with decompression of the
      trigeminalnerve and preservation of its regular function. The most common procedures in
      treating TN pain are the use of radiofrequency (RF) .

      Radiofrequency thermos-coagulation of the GG is thought to selectively destroy the pain
      fibers by thermos-coagulation at > 65°C , that helps reduce pain and prevent triggering, but
      can cause bothersome dysesthesia. Another method, pulsed radiofrequency (PRF) which defined
      as the delivery of short pulses of RF via a needle tip, thereby a short exposure at the same
      temperature will result in less thermal tissue destruction (6).

      Combined conventional and pulsed radiofrequency (CCPRF) achieved comparable pain relief to
      PRF treatment alone in patients with chronic pain, the combination of PRF and CRF would
      increase the effect of CRF and reduce the need for long-duration CRF (LCRF) and its attendant
      side effects .

      The main objective of this study is to assess the possible value of motor index as a
      prediction of success of radiofrequency lesioning of the Gasserian ganglion during treatment
      of trigeminal neuralgia.
    

Intervention name(s): combined conventional and pulsed radiofrequency (CCPRF)
Intervention type(s): Procedure
Intervention description(s): Patients with trigeminal neuralgia who underwent combined conventional and pulsed radiofrequency (CCPRF) for treatment of pain.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment