Retrospective evaluation of treatment outcomes of Gasserian ganglion radiofrequency thermocoagulation in trigeminal neuralgia patients with multiple sclerosis

TL;DR

This study evaluates the effectiveness of a combined radiofrequency treatment for trigeminal neuralgia in patients with multiple sclerosis, finding it to be safe and effective for pain relief.

Contribution

The paper presents one of the most extensive case series on combined RFT and PRF for MS-related trigeminal neuralgia.

Findings

All patients experienced over 50% pain relief at six months.

75% of patients had sustained relief at 12 months.

No significant procedure-related complications were observed.

Abstract

Trigeminal neuralgia (TN) secondary to multiple sclerosis (MS) is a rare but debilitating condition. Aside from two case reports, there are limited data on the use of Gasserian ganglion radiofrequency interventions in this patient population. This study aims to evaluate the outcomes of combined radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) treatment targeting the Gasserian ganglion in patients with MS-related TN.

We retrospectively analyzed 12 patients with MS-associated TN who underwent combined Gasserian ganglion RFT and PRF treatment between 1 January 2021 and 1 January 2025. Patients were followed for six months. Visual analog scale (VAS) scores, treatment efficacy, and adverse events were recorded.

The mean age was 55.2 ± 7.7 years, with a female predominance (58.3%). The average MS duration was 16.4 ± 4.6 years; one-third of patients had relapsing–remitting MS. TN was more commonly left-sided (58.3%). Interventions targeted V2 (16.7%), V3 (41.7%), or both branches (41.7%). At six months, all patients experienced >50% pain relief; sustained relief was observed in 75% of patients at 12 months.

To our knowledge, this may represent one of the most extensive retrospective case series evaluating the combined use of RFT and PRF in patients with MS-related TN. The treatment was found to be effective and well-tolerated, with no significant procedure-related complications observed. While the results are encouraging, further prospective studies with larger sample sizes are warranted to validate these findings.

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