Abstract
Background and Objective Microsurgical vascular nerve decompression and percutaneous ablative interventions
aiming at the Gasserian ganglion are promising treatment modalities for patients with
medical refractory trigeminal neuralgia (TN). Apart from clinical reports on a variable
manifestation of facial hypoesthesia, the long-term impact of trigeminal ganglion
radiofrequency thermocoagulation (RFT) on sensory characteristics has not yet been
determined using quantitative methods.
Material and Methods We performed standardized quantitative sensory testing according to the established
protocol of the German Research Network on Neuropathic Pain in a cohort of patients
with classical (n = 5) and secondary (n = 11) TN before and after percutaneous Gasserian ganglion RFT (mean follow-up: 6
months). The test battery included thermal detection and thermal pain thresholds as
well as mechanical detection and mechanical pain sensitivity measures. Clinical improvement
was also assessed by means of renowned pain intensity and impairment questionnaires
(Short-Form McGill Pain Questionnaire, Pain Disability Index, and Pain Catastrophizing
Scale), pain numeric rating scale, and anti-neuropathic medication reduction at follow-up.
Results All clinical parameters developed favorably following percutaneous thermocoagulation.
Only mechanical and vibration detection thresholds of the affected side of the face
were located below the reference frame of the norm population before and after the
procedure. Statistically significant persistent changes in quantitative sensory variables
caused by the intervention could not be detected in our patient sample.
Conclusion Our data suggest that TN patients improving considerably after RFT do not undergo
substantial long-term alterations regarding quantitative sensory perception.
Keywords trigeminal neuralgia - thermocoagulation - lesioning - quantitative sensory - testing
