title: The efficacy and safety of combined pulsed and conventional radiofrequency treatment of refractory cases of idiopathic trigeminal neuralgia: a retrospective study.
abstract: OBJECTIVE
  We conducted a retrospective study to evaluate the efficacy and duration of pain relief for idiopathic trigeminal neuralgia (TN) patients after continuous radiofrequency (CRF) combined with pulsed radiofrequency (PRF) treatment of the Gasserian ganglion (GG).
  
  
  METHODS
  Twenty-one patients were treated with pulsed RF for 6 min repeated after rotating the needle tip by 180°, at a pulse width of 10 ms and at 45 °C. This was followed by conventional RF at 60 °C for 60 s, repeated after needle rotation by 180°, then finally at 65 °C for 60 s also repeated after needle rotation by 180°. Patients were assessed for pain intensity and consumption of analgesics at baseline and 7 days, 1 month, 6 months, and 12 months after the procedure. The patients' global impression of change (PGIC) scale was also assessed 7 days, 1 month, 6 months, and 12 months after the procedure. The incidence of facial dysthesia was evaluated 7 days after the procedure.
  
  
  RESULTS
  Excellent pain relief was achieved for 15 of 21 patients (71.4 %) after 1 week, 1 month, and 6 months. and for 14 of 21 patients (66.7 %) after 12 months. Consumption of analgesics was significantly reduced for more than 6 months, and for fifteen patients the PGIC scale result was very much improved 12 months after the procedure compared with baseline. Eighteen of the 21 patients (85.7 %) experienced facial dysthesia 1 week after the procedure.
  
  
  CONCLUSIONS
  Excellent pain relief and reduced consumption of analgesics for more than 6 months were observed in patients who received PRF combined with CRF to the GG for treatment of idiopathic TN.
authors.affiliation: Department of Anesthesiology and Pain management, Faculty of Medicine, Alazhar University, Nasr City, Cairo, Egypt. dralieissa@hotmail.com.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Ali Eissa
authors.affiliation: Department of Anesthesiology and Pain management, National Cancer Institute, Cairo University, Cairo, Egypt. dr_raafat2006@hotmail.com.
authors.forename: Raafat M
authors.initials: RM
authors.lastname: Reyad
authors.affiliation: Department of Anesthesiology and Pain management, National Cancer Institute, Cairo University, Cairo, Egypt. emadgr2005@yahoo.com.
authors.forename: Emad G
authors.initials: EG
authors.lastname: Saleh
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: El-Saman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D012189:Retrospective Studies; D014277:Trigeminal Neuralgia / Q000628:therapy*
keywords: Conventional radiofrequency; Idiopathic trigeminal neuralgia; Pulsed radiofrequency