gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Peripheral nerve field stimulation for facial pain

Meeting Abstract

  • Johann Klein - Klinik für Neurochirurgie, Universitätsklinikum Dresden
  • Sahr Sandi-Gahun - Klinik für Neurochirurgie, Universitätsklinikum Dresden
  • Gabriele Schackert - Klinik für Neurochirurgie, Universitätsklinikum Dresden
  • Tareq Juratli - Klinik für Neurochirurgie, Universitätsklinikum Dresden

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 110

doi: 10.3205/15dgnc508, urn:nbn:de:0183-15dgnc5082

Published: June 2, 2015

© 2015 Klein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Peripheral nerve field stimulation has been reported to be a promising modality for the treatment of intractable facial pain, mostly of neuropathic origin. However, evidence is sparse. We therefore present our experience with this minimally invasive technique in eight patients.

Method: We retrospectively analyzed the outcome of all patients, who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation (Medtronic Pisces Quad Plus, IPG: PrimeAdvanced). All patients were followed up in our outpatient department and/or contacted via telephone.

Results: In eight patients (four male) a stimulation system was implanted after successful trial stimulation. Five patients suffered from idiopathic trigeminal neuralgia (four type 1, one type 2), two from symptomatic trigeminal neuralgia due to multiple sclerosis and one from atypical facial pain without a neuropathic component. Average patient age was 74.3 years (range 57-87), average symptom duration was 11.9 years (range 6-17). Four of the patients had had microvascular decompression surgery before. Average pain intensity was 9.3 out of 10 (range 7-10) preoperatively and 0.6 (range 0-3) postoperatively. Five patients reported complete absence of pain with stimulation. Average follow-up was 10.8 months (range 3-26). In one patient, an electrode malfunction required a revision with excellent results. In another, a dislocation of the IPG occurred which did not compromise the function; the patient did not wish a revision. A third patient required a debridement due to a minor wound healing deficiency. No serious complications and no morbidity arose.

Conclusions: Peripheral nerve field stimulation appears to be a safe and effective treatment option for refractory trigeminal neuropathic pain even in an elderly population with comorbidities and yields a high patient satisfaction. Likewise, a patient with atypical facial pain showed significant reduction in pain intensity.