Abstract
INTRODUCTION
Percutaneous pulsed radiofrequency (PPRF) is a minimally invasive neuromodulation technique used in chronic pain management. Our aim was to evaluate its effectiveness and safety in refractory cases of trigeminal neuralgia (TN) and chronic cluster headache (CH).
METHODS
We conducted a retrospective study of patients with TN and CH diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria and treated with PPRF (Gasserian ganglion for TN and sphenopalatine ganglion for CH) over an 8-year period. Effectiveness at 3 months was assessed by evaluating reduction in the number of pain days in TN and number of attacks in CH, ≥50% response rate, visual analogue scale (VAS), Patient Global Impression of Improvement (PGI-I), and pain recurrence.
RESULTS
Twenty-five patients met the inclusion criteria, including 19 with TN and 6 with CH, with a mean age of 76 and 52 years, respectively. Clinical improvement was observed in 14/19 (73.6%) patients with TN and 5/6 (83.3%) patients with CH. A ≥50% response rate was achieved in 11/14 (78.6%) patients with TN and 4/6 (66.7%) patients with CH. VAS scores decreased at 3 months in both groups ( p p = 0.06 in CH). PGI-I was rated as "better" or "much better" in 10/19 (52.6%) patients with TN and 5/6 (83.3%) patients with CH. Pain recurrence occurred in 13/14 (92.8%) patients with TN and 5/5 (100%) patients with CH, mainly after 1 year following the first procedure (7/13 TN and 2/5 CH). No major adverse events were reported.
CONCLUSIONS
In our series, PPRF appears to be an effective and safe treatment for refractory TN and CH. Although the study is retrospective and the sample size is limited, particularly in CH, these findings should be considered preliminary but clinically relevant. Despite the high recurrence rate, given its low complication profile, it may represent a treatment option for patients who are not candidates for surgical procedures.