Effect of Repeated Pulsed Radiofrequency for Trigeminal Herpes Zoster Neuralgia: A Retrospective Study

Background: The quality of life for patients suffering from trigeminal herpes zoster neuralgia (TG-HZN) is significantly compromised due to the persistent pain associated with this condition. Pulsed radiofrequency (PRF) has emerged as an effective treatment option. Currently, most patients opt for a single PRF treatment; however, some individuals report inadequate analgesic effects, short durations of pain relief, and overall instability in efficacy. Repeated PRF may enhance therapeutic benefits and improve patient satisfaction. Objective: This retrospective study aimed to evaluate the efficacy of repeated PRF compared to a single PRF in patients with TG-HZN. Patients and Methods: We conducted a retrospective analysis of data from 107 TG-HZN patients who underwent CT-guided selective extracranial PRF neurolysis targeting the mandibular branch within the foramen ovale during a one-week hospitalization period. Participants were divided into two groups: single PRF (once PRF, Group S-PRF) and repeated PRF (twice PRF, Group R-PRF). To assess outcomes pre- and post-treatment, we utilized the numeric rating scale (NRS), Pittsburgh Sleep Quality Index (PSQI), and measured the incidence of clinically significant trigeminal postherpetic neuralgia (TG-PHN). Results: The NRS and PSQI scores of the group R-PRF were significantly lower than those of the group S-PRF at the 1st, 4th, 8th, 12th, and 24th weeks post-treatment ( P < 0.05). Additionally, the incidence of clinically meaningful TG-PHN in the group R-PRF was notably lower than that in the group S-PRF at the 12th and 24th weeks post-treatment ( P < 0.05). Conclusion: Repeated pulsed radiofrequency treatments demonstrated substantial efficacy in managing trigeminal herpes zoster neuralgia while also exhibiting superior effectiveness in decreasing the incidence of clinically significant trigeminal postherpetic neuralgia. Keywords: pulsed radiofrequency, trigeminal, herpes zoster neuralgia, repeated, retrospective