A case of pulsed radiofrequency lesioning for occipital neuralgia

被引:42
作者
Navani, Annu
Mahajan, Gagan
Kreis, Paul
Fishman, Scott M.
机构
[1] Bay Area Pain Ctr, Los Gatos, CA USA
[2] Stanford Univ, Sch Med, Dept Anesthesiol, Div Pain Management, Palo Alto, CA 94304 USA
[3] Univ Calif Davis, Dept Anesthesiol, Div Pain Med, Davis Med Ctr, Davis, CA 95616 USA
关键词
greater occipital neuralgia; greater occipital nerve block; pulsed radiofrequency; occipital headache;
D O I
10.1111/j.1526-4637.2006.00217.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective. This report describes a case where pulsed radiofrequency lesioning (RFL) of the greater occipital nerve (GON) offered a valuable and safe treatment for the management of greater occipital neuralgia. The case is considered in relation to a review of the medical literature on greater occipital neuralgia and RFL interventions. Case Report. A 62-year-old man with a 43-year history of left suboccipital pain underwent pulsed RFL of the left GON (20-millisecond bursts at intervals of 0.5 second for 4 minutes at 42 degrees C) after failing to achieve substantial analgesia with naproxen, a transcutaneous electrical nerve stimulator (TENS) unit and a greater occipital nerve blockade (GONB) utilizing local anesthetic and steroid. After obtaining 4 months of 70% pain relief, pulsed RFL was repeated and resulted in an additional 5 months of 70% pain relief. Conclusions. Pulsed RFL of the GON is an alternative to continuous RFL with the proposed advantage of mitigating pain, as in continuous RFL, but without the potential risk of causing deafferentation pain. While placebo and other nonspecific analgesic effects cannot be ruled out, the apparent safety profile and potential efficacy of pulsed RFL suggests it may be a compelling option to consider before irreversible neuroablative therapies are applied.
引用
收藏
页码:453 / 456
页数:4
相关论文
共 11 条
[1]  
Anthony M., 1985, UPDATING HEADACHE, P17
[2]   Extracranial nerves in the posterior part of the head - Anatomic variations and their possible clinical significance [J].
Becser, N ;
Bovim, G ;
Sjaastad, O .
SPINE, 1998, 23 (13) :1435-1441
[3]   OCCIPITAL NERVE BLOCK IN THE MANAGEMENT OF HEADACHE AND CERVICAL PAIN [J].
GAWEL, MJ ;
ROTHBART, PJ .
CEPHALALGIA, 1992, 12 (01) :9-13
[4]   Exposure of the dorsal root ganglion in rats to pulsed Radiofrequency currents activates dorsal horn lamina I and II neurons [J].
Higuchi, Y ;
Nashold, BS ;
Sluijter, M ;
Cosman, E ;
Pearlstein, RD .
NEUROSURGERY, 2002, 50 (04) :850-855
[5]   Radiofrequency ablation for chronic pain control [J].
Kapural L. ;
Mekhail N. .
Current Pain and Headache Reports, 2001, 5 (6) :517-525
[6]   The longer term effect of pulsed radiofrequency for neuropathic pain [J].
Munglani, R .
PAIN, 1999, 80 (1-2) :437-439
[7]   Use of an ultrasound Doppler flowmeter for occipital nerve block [J].
Okuda, Y ;
Ishikawa, K ;
Usui, Y ;
Nagao, M ;
Ikeda, T ;
Kitajima, T .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2002, 27 (04) :444-445
[8]  
RACZ GB, 1996, INTERVENTIONAL PAIN, P295
[9]   FLUNARIZINE IN PROPHYLAXIS OF CHILDHOOD MIGRAINE - A DOUBLE-BLIND, PLACEBO-CONTROLLED, CROSSOVER STUDY [J].
SORGE, F ;
DESIMONE, R ;
MARANO, E ;
NOLANO, M ;
OREFICE, G ;
CARRIERI, P .
CEPHALALGIA, 1988, 8 (01) :1-6
[10]   Long-lasting analgesic effect of radiofrequency treatment of the lumbosacral dorsal root ganglion [J].
van Wijk, RMAW ;
Geurts, JWM ;
Wynne, HJ .
JOURNAL OF NEUROSURGERY, 2001, 94 (02) :227-231