Open AccessA Case of Pulsed Radiofrequency Lesioning for Occipital Neuralgia
Author(s) -
Navani Annu,
Mahajan Gagan,
Kreis Paul,
Fishman Scott M.
Publication year - 2006
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2006.00217.x
Subject(s) - occipital neuralgia , medicine , anesthesia , pulsed radiofrequency , trigeminal neuralgia , analgesic , local anesthetic , occipital nerve stimulation , neuralgia , anesthetic , pain relief , neuropathic pain , alternative medicine , pathology
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°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.