Ultrasound-guided peripheral nerve radiofrequency ablation for craniofacial postherpetic neuralgia: efficacy and safety in a retrospective cohort

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-06-20 DOI:10.1016/j.jocn.2025.111408

Ying Li , Xin Zeng , Lei Zhou

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引用次数: 0

Abstract

Background

Craniofacial postherpetic neuralgia (PHN), though relatively uncommon, presents significant clinical challenges through chronic headache and facial pain manifestations. This study aimed to assess the efficacy of ultrasound-guided peripheral nerve radiofrequency ablation (RFA) for craniofacial zoster-related pain.

Methods

A total of 91 patients with cephalofacial PHN admitted to the Renmin Hospital of Wuhan University from January 2023 and December 2024 were retrospectively analyzed. All patients were treated with ultrasound-guided peripheral nerve (supraorbital, infraorbital, mental, and greater occipital nerves) RFA. Pain intensity, sleep quality, and quality of life were objectively quantified using standardized metrics: Visual Analog Scale (VAS) for nociceptive assessment, 5-item validated questionnaire for sleep evaluation, and 36-Item Short Form Health Survey (SF-36) for multidimensional functional analysis. Both pharmacological protocols and post-RFA complications were systematically documented.

Results

RFA demonstrated significant therapeutic outcomes: VAS scores decreased from 6.7 ± 1.0 to 2.2 ± 1.3 (p < 0.001), accompanied by SF-36 improvement and enhanced sleep quality (6.0 ± 3.4 vs. 10.7 ± 2.4; p < 0.001). Medication requirements substantially reduced, with pregabalin decreasing from 292 ± 74 mg to 70 ± 91 mg and tramadol from 163 ± 61 mg to 38 ± 63 mg (both p < 0.001). Postoperative complications analysis (n = 64) revealed cutaneous hypoesthesia as the most prevalent (82.8 %, 53/64), followed by puncture-site edema (57.8 %, 37/64). Less frequent occurrences included periorbital ecchymosis (15.6 %, 10/64), de novo neuralgia (7.8 %, 5/64), transient visual disturbances (4.7 %, 3/64), and localized infections (3.1 %, 2/64).

Conclusion

Ultrasound-guided peripheral nerve RFA effectively alleviates craniofacial zoster-related pain with concomitant improvements in quality of life and sleep metrics, though sustained vigilance regarding long-term sequelae remains clinically imperative.

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超声引导周围神经射频消融术治疗颅面疱疹后神经痛：回顾性队列的有效性和安全性

颅面疱疹后神经痛（PHN）虽然相对不常见，但通过慢性头痛和面部疼痛表现给临床带来了重大挑战。本研究旨在评估超声引导下周围神经射频消融术（RFA）治疗颅面带状疱疹相关疼痛的疗效。方法回顾性分析武汉大学人民医院2023年1月至2024年12月收治的91例颅面PHN患者的临床资料。所有患者均行超声引导下周围神经（眶上神经、眶下神经、精神神经和枕大神经）射频消融术。使用标准化指标客观量化疼痛强度、睡眠质量和生活质量：视觉模拟量表（VAS）用于伤害性评估，5项有效问卷用于睡眠评估，36项简短健康调查（SF-36）用于多维功能分析。系统地记录了药理学方案和rfa后并发症。结果rfa显示了显著的治疗效果：VAS评分从6.7±1.0降至2.2±1.3 (p <；0.001)，伴有SF-36的改善和睡眠质量的提高(6.0±3.4 vs 10.7±2.4；p & lt;0.001)。用药需求大幅减少，普瑞巴林从292±74 mg降至70±91 mg，曲马多从163±61 mg降至38±63 mg (p <；0.001)。术后并发症分析（n = 64）显示，皮肤感觉减退最常见（82.8%,53/64），其次是穿刺部位水肿（57.8%,37/64）。较少见的包括眼眶周围瘀斑（15.6%,10/64）、新发神经痛（7.8%,5/64）、一过性视力障碍（4.7%,3/64）和局部感染（3.1%,2/64）。结论超声引导下周围神经RFA可有效缓解颅面带状疱疹相关疼痛，同时改善生活质量和睡眠指标，但临床仍需对长期后遗症保持警惕。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.