{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:02:50Z","timestamp":1791525770949,"version":"4.3.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Unlike idiopathic trigeminal neuralgia, which can be treated with conventional neurosurgical methods such as microvascular decompression, radiofrequency rhizotomy of the Gasser ganglion, or stereotactic radiosurgery, trigeminal neuropathic pain (TNP) presents a major challenge for neurosurgeons. Injury to the trigeminal system resulting in chronic refractory pain can be treated with neuromodulation methods, such as peripheral nerve stimulation, motor cortex stimulation, or deep brain stimulation. Sphenopalatine ganglion (SPG) stimulation has been successfully applied in patients with cluster headaches and migraine. This study aimed to evaluate the response of patients with TNP to permanent percutaneous SPG stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied six patients treated with SPG stimulation for TNP. All patients had previously been treated with RF rhizotomy, microvascular decompression, or stereoradiosurgery without a satisfactory long-term therapeutic effect and had recurrent, mostly constant TNP. An electrode lead was implanted in the pterygopalatine fossa of all patients to stimulate the SPG under guidance of neuronavigation with an implantable pulse generator inserted after a two-week trial period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperatively, the mean visual analog scale score was 9. Two weeks after the trial stimulation, it decreased to 3.6 in six patients. In four patients, the score further decreased to 3.0 after 6\u202fmonths and 2.25 after 12\u202fmonths, accompanied by an improvement in health status, as measured by the 36-Item Short Form Health Survey questionnaire. In two patients, the electrodes were externalized through eroded skin after 3\u202fmonths, and stimulators were removed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The preliminary results of this pilot study are encouraging. Pain relief after the trial stimulation was found to be notable. The treatment procedure was safe, and the stimulation effect was durable. SPG stimulation is an attractive alternative to other neuromodulation methods.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1535102","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:11:05Z","timestamp":1747195865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Sphenopalatine ganglion stimulation for the treatment of trigeminal neuropathic pain"],"prefix":"10.3389","volume":"16","author":[{"given":"Pawe\u0142","family":"Sokal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Kiero\u0144ska-Siwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Rusinek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Jab\u0142o\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Nehring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Puk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Palus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Jab\u0142o\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1136\/practneurol-2020-002782","article-title":"Trigeminal neuralgia: a practical guide","volume":"21","author":"Lambru","year":"2021","journal-title":"Pract Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1227\/01.NEU.0000088806.11659.D8","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003","journal-title":"Neurosurgery"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s10143-022-01922-0","article-title":"Clinical outcome after microvascular decompression for trigeminal neuralgia: a systematic review and meta-analysis","volume":"46","author":"Di Carlo","year":"2022","journal-title":"Neurosurg Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.clineuro.2019.05.011","article-title":"Comparative safety and efficacy of percutaneous approaches for the treatment of trigeminal neuralgia: a systematic review and meta-analysis","volume":"182","author":"Texakalidis","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"733","DOI":"10.3171\/2017.9.JNS17545","article-title":"Stereotactic radiosurgery for trigeminal neuralgia: a systematic review","volume":"130","author":"Tuleasca","year":"2019","journal-title":"J Neurosurg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1093\/neuros\/nyy552","article-title":"Deep brain stimulation for pain in the modern era: a systematic review","volume":"86","author":"Frizon","year":"2020","journal-title":"Clin Neurosurg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"7195","DOI":"10.1038\/s41598-020-64177-z","article-title":"Motor cortex stimulation in chronic neuropathic orofacial pain syndromes: a systematic review and meta-analysis","volume":"10","author":"Henssen","year":"2020","journal-title":"Sci Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s10194-017-0826-y","article-title":"Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation\u2014a systematic review","volume":"18","author":"Ho","year":"2017","journal-title":"J Headache Pain"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/j.1533-2500.2011.00507.x","article-title":"The pterygopalatine ganglion and its role in various pain syndromes: from anatomy to clinical practice","volume":"12","author":"Piagkou","year":"2012","journal-title":"Pain Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"375","DOI":"10.2147\/JPR.S129641","article-title":"Managing cluster headache with sphenopalatine ganglion stimulation: a review","volume":"11","author":"Fontaine","year":"2018","journal-title":"J Pain Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1265540","DOI":"10.3389\/fpain.2023.1265540","article-title":"Cluster headache: state of the art in treatment","volume":"4","author":"Rodriguez-Leyva","year":"2023","journal-title":"Front Pain Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1177\/0333102412473667","article-title":"Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. 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