gms | German Medical Science

Objective: Neuropathic and chronic trigeminal pain can be difficult to treat. Minimally invasive neuromodulation techniques are required. Subcutaneous stimulation (sQS) is certified to treat chronic lower back pain. We present the results of our case series using this technique in the trigeminal area.

Method: We present our series of n=7 cases of trigeminal sQS. After successful trial stimulation for 7-14 days, patients had electrodes implanted in the area of affected trigeminal branches connected to an infraclavicular neurostimulator. Follow-up visits were performed after 1, 3, 12 months and then annually.

Results: N=5 patients had idiopathic trigeminal neuralgia, n=2 patients suffered from postherpetic neuropathy. All patients with idiopathic trigeminal neuralgia had received microvascular decompression before. Mean VAS scores were reduced from 8.9 to 1.4. N=3 patients could stop and n=4 patients could reduce their pain medication. Not only the pain intensity but also the number of painful attacks could be reduced by continuous stimulation Mean follow-up is 15.6 months (3-32 months). N=1 patient developed infection with temporary loss of system. 2 patients experienced transitory stimulation side effects that could be solved with reprogramming.

Conclusions: Subcutaneous nerve field stimulation can be used to effectively treat neuropathic and chronic trigeminal pain with limited invasiveness and minimal side-effects as well as patient empowerment.