title: Peripheral neuromodulation for the treatment of refractory trigeminal neuralgia.
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.
authors.forename: Naum
authors.initials: N
authors.lastname: Shaparin
authors.forename: Karina
authors.initials: K
authors.lastname: Gritsenko
authors.forename: Diego Fernandez
authors.initials: DF
authors.lastname: Garcia-Roves
authors.forename: Ushma
authors.initials: U
authors.lastname: Shah
authors.forename: Todd
authors.initials: T
authors.lastname: Schultz
authors.forename: Oscar
authors.initials: O
authors.lastname: DeLeon-Casasola
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010525:Peripheral Nerves / Q000502:physiology; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000628:therapy*
references.citation: CNS Drugs. 2013 Feb;27(2):91-6
references.pmid: 23225488
references.citation: J Neurol Neurosurg Psychiatry. 1990 Dec;53(12):1034-42
references.pmid: 2292693
references.citation: Cephalalgia. 2008 Jul;28(7):799-803
references.pmid: 18547217
references.citation: Brain. 2002 Jul;125(Pt 7):1496-509
references.pmid: 12077000
references.citation: Pain. 1984 Mar;18(3):249-65
references.pmid: 6728494
references.citation: Clin J Pain. 2004 Nov-Dec;20(6):462-8
references.pmid: 15502691
references.citation: Eur J Neurol. 2008 Oct;15(10):1013-28
references.pmid: 18721143
references.citation: Pain Physician. 2008 Mar-Apr;11(2):187-200
references.pmid: 18354711
references.citation: Science. 1965 Nov 19;150(3699):971-9
references.pmid: 5320816
references.citation: Headache. 2007 Jul-Aug;47(7):1100-2
references.pmid: 17635606
references.citation: Anesth Analg. 2005 Jul;101(1):171-4, table of contents
references.pmid: 15976227
references.citation: JAMA. 1994 May 25;271(20):1609-14
references.pmid: 7880221
references.citation: Rheumatol Int. 1984;4(3):119-23
references.pmid: 6611576
references.citation: Clin Neurosurg. 2009;56:119-24
references.pmid: 20214042
references.citation: Neurosurg Focus. 2006;21(6):E5
references.pmid: 17341049
references.citation: Pain. 1997 Oct;73(1):23-8
references.pmid: 9414053
references.citation: J Pain. 2003 Nov;4(9):530-4
references.pmid: 14636821
references.citation: J Neurosurg. 1991 Aug;75(2):244-50
references.pmid: 2072161
references.citation: Lancet Neurol. 2009 Aug;8(8):755-64
references.pmid: 19608101
references.citation: Neuromodulation. 2005 Jan;8(1):7-13
references.pmid: 22151378
references.citation: Curr Opin Neurol. 2009 Jun;22(3):262-8
references.pmid: 19434793
references.citation: Cephalalgia. 2011 Oct;31(13):1405-8
references.pmid: 21628443
references.citation: Cephalalgia. 2013 Jul;33(9):629-808
references.pmid: 23771276
references.citation: Pain. 2014 Jan;155(1):37-44
references.pmid: 23999058
references.citation: Neuromodulation. 2009 Jan;12(1):1-4
references.pmid: 22151216
references.citation: Am J Hosp Palliat Care. 2010 Feb;27(1):59-62
references.pmid: 19700650
references.citation: Brain. 2004 Jan;127(Pt 1):220-30
references.pmid: 14607792
references.citation: Neurosurgery. 2004 Jul;55(1):135-41; discussion 141-2
references.pmid: 15214982