title: Pulsed Radiofrequency: A Management Option for Recurrent Trigeminal Neuralgia Following Radiofrequency Thermocoagulation.
abstract: BACKGROUND
  Pain relief comparable with radiofrequency thermocoagulation (RFT) alone and fewer side effects than RFT have been achieved by combination treatment with pulsed radiofrequency (PRF) and short-duration RFT in trigeminal neuralgia (TN).
  
  
  METHODS
  We report the successful management of recurrent TN after RFT with single PRF in 2 patients. The RFT treatment was performed in 2-3 cycles for each division, with the lesion setting at 75°C-80°C for 90 seconds. The PRF treatment was applied for 120 seconds, with a generator output of 45 V, not exceeding a temperature of 42°C at the tip of the electrode. In case 1, pain relief was immediately achieved by RFT (75°C for 90 seconds), with moderate hypesthesia. Relapse of the triggered pain occurred 6 months later, and PRF was then applied. Long-term (18 months) pain relief without any additional pharmacologic or other treatment was reported. In case 2, a second RFT treatment at a higher temperature (80°C) was performed after recurrence after the first RFT within a week. Accompanied by worse hypesthesia, complete pain relief lasted for 6 months until the recurrence of pain was triggered by toothbrushing. PRF was then applied, and complete analgesia with long-term follow-up (28 months) was achieved.
  
  
  CONCLUSIONS
  The PRF treatment for recurrent TN after RFT in this study could be viewed as a combination of PRF and RFT treatments in succession. Therefore, PRF and RFT should be considered to be complementary rather than alternative in the management of TN.
authors.affiliation: Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China.
authors.forename: Chenlong
authors.initials: C
authors.lastname: Liao
authors.affiliation: Department of Neurosurgery, Catholic University School of Medicine, Largo A. Gemelli, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Visocchi
authors.affiliation: Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China.
authors.forename: Shiting
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China. Electronic address: zhangwench88@hotmail.com.
authors.forename: Wenchuan
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D012008:Recurrence; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000628:therapy*
keywords: Pulsed radiofrequency; Radiofrequency thermocoagulation; Trigeminal neuralgia