Abstract
Trigeminal neuralgia is a type of orofacial pain that is diagnosed in 150,000 individuals each year, with an incidence of 12.6 per 100,000 person-years and a prevalence of 155 cases per 1,000,000 in the United States. Trigeminal neuralgia pain is characterized by sudden, severe, brief, stabbing or lancinating, recurrent episodes of pain in the distribution of one or more branches of the trigeminal nerve, which can cause significant suffering for the affected patient population. In many patients, a combination of medication and interventional treatments can be therapeutic, but is not always successful. Peripheral nerve stimulation has gained popularity as a simple and effective neuromodulation technique for the treatment of many pain conditions, including chronic headache disorders. Specifically in trigeminal neuralgia, neurostimulation of the supraorbital and infraorbital nerves may serve to provide relief of neuropathic pain by targeting the distal nerves that supply sensation to the areas of the face where the pain attacks occur, producing a field of paresthesia within the peripheral distribution of pain through the creation of an electric field in the vicinity of the leads. The purpose of the present case report is to introduce a new, less-invasive interventional technique, and to describe the authors' first experience with supraorbital and infraorbital neurostimulation therapy for the treatment of trigeminal neuralgia in a patient who had failed previous conservative management.
Highlights
Trigeminal neuralgia is a type of orofacial pain that is diagnosed in 150,000 individuals each year, with an incidence of 12.6 per 100,000 person-years and a prevalence of 155 cases per 1,000,000 in the United States
It has been suggested that medical treatment to control pain in patients with Trigeminal neuralgia (TN) should include carbamazepine or oxcarbazepine, with very little benefit observed among patients who were tried on other oral agents [5]
Surgical therapy for TN is generally well tolerated, a potential complication is anesthesia dolorosa, a condition characterized by persistent, painful anesthesia or hyperesthesia in the denervated region, which can be more intolerable than the pain from TN itself [7]
Summary
Trigeminal neuralgia is a type of orofacial pain that is diagnosed in 150,000 individuals each year, with an incidence of 12.6 per 100,000 person-years and a prevalence of 155 cases per 1,000,000 in the United States. Peripheral nerve stimulation has gained popularity as a simple and effective neuromodulation technique for the treatment of many pain conditions, including chronic headache disorders. The purpose of the present case report is to introduce a new, lessinvasive interventional technique, and to describe the authors’ first experience with supraorbital and infraorbital neurostimulation therapy for the treatment of trigeminal neuralgia in a patient who had failed previous conservative management. La neuromodulation périphérique pour traiter la névralgie réfractaire du trijumeau La névralgie du trijumeau est un type de douleur buccofaciale diagnostiquée chez 150 000 personnes chaque année, pour une incidence de 12,6 cas sur 100 000 personnes-année et une prévalence de 155 cas sur 1 000 000 habitants des États-Unis. La stimulation des nerfs périphériques a gagné en popularité, car c’est une technique de neurostimulation simple et efficace pour traiter de nombreuses douleurs, y compris les céphalées chroniques. Dans le cas de la névralgie du trijumeau, la neurostimulation des nerfs sus-orbitaire et infraorbitaire pourrait soulager la douleur neuropathique en ciblant les nerfs distaux qui transmettent la sensation dans les régions du visage où les crises de douleur se manifestent et qui produisent un champ de paresthésie dans la distribution périphérique de la douleur grâce à la création d’un champ électrique à proximité des dérivations
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