Peripheral trigeminal branch stimulation for refractory facial pain: A single-center experience

Pavlos Texakalidis, Muhibullah S. Tora, Casey L. Anthony, Alexander Greven, J. Tanner McMahon, Purva Nagarajan, Willard S. Kasoff, Nicholas AuYong, Nicholas M. Boulis

Research output: Contribution to journalArticle

Abstract

Objective: Facial pain refractory to medical treatments may benefit from neurosurgical interventions. Only a few studies have reported on the efficacy of peripheral trigeminal stimulation and more specifically supraorbital nerve (SON) and infraorbital nerve (ION) stimulation for the treatment of facial pain. Patients and methods: In the present study, we identified all patients at our institution who underwent SON and/or ION stimulation for treatment of facial pain due to post-herpetic, traumatic or idiopathic etiology. Relevant pre and post-operative outcomes were analyzed. Results: We identified 15 patients who underwent SON and/or ION stimulation. Among them, 12 (80 %) endorsed >50 % pain relief during the trial stimulation period. After a median follow-up of 5.8 months with permanent implantation, 1 patient (8.3 %) was diagnosed with lead erosion and IPG migration, two patients had lead infections (16.7 %) and one (8.3 %) had wound dehiscence. No lead migrations were identified during the long-term follow-up. The VAS score showed a statistically significant reduction from a median pre-operative score of 7 to a post-operative score of 1.8 (p = 0.011), which corresponded to a 74.3 % average pain reduction. Conclusion: SON and/or ION stimulation can be an effective treatment for intractable facial pain due to post-herpetic, traumatic or idiopathic etiology; however the complication rate is relatively high. Future prospective studies with longer follow-up periods are warranted.

Original languageEnglish (US)
Article number105819
JournalClinical Neurology and Neurosurgery
Volume194
DOIs
StatePublished - Jul 2020

Keywords

  • Facial pain
  • Infraorbital nerve
  • Neuropathic pain
  • Stimulation
  • Supraorbital nerve
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Texakalidis, P., Tora, M. S., Anthony, C. L., Greven, A., McMahon, J. T., Nagarajan, P., Kasoff, W. S., AuYong, N., & Boulis, N. M. (2020). Peripheral trigeminal branch stimulation for refractory facial pain: A single-center experience. Clinical Neurology and Neurosurgery, 194, [105819]. https://doi.org/10.1016/j.clineuro.2020.105819