New Treatments

Has someone heard about the PNS treatment? My doctor mentioned is something still under Clinical trials but designed for TN. Comments anyone?

Sorry but PNS=???.

Regards, Red

Maybe this stands for Peripheral Nerve Stimulation?

Thank you Suzanne... I'm not aware of a clinical trial underway for peripheral nerve stimulation. But I've heard patient reports from more than one individual which cautioned against use of TENS devices due to severe trigger zone reactions. I may do some further sniffing around at NIH to see what turns up.

There are two drugs now in trials that appear to have promise. One is a blocker which is specific to one of the Sodium channels in the trigeminal system, and has been proposed for both Migraine and TN. That one is being done in the UK. A second trial in mice has been brought through Stage I, for development of a T-cell based therapy for repairing damage to the Myelin layer of nerves. That one is under the sponsorship of the Myelin Repair Foundation here in the US.

Regards, REd

Interesting: Here is an abstract I missed from work that is somewhat dated:

Peripheral Stimulation for Treatment of Trigeminal Postherpetic Neuralgia and Trigeminal Posttraumatic Neuropathic Pain: A Pilot Study

Johnson, Mark D. M.D., Ph.D.; Burchiel, Kim J. M.D.

Collapse Box

Abstract

OBJECTIVE: Trigeminal neuropathic pain (TNP) after facial trauma or herpes zoster infection is often refractory to treatment. Peripheral nerve stimulation has been used to treat occipital neuralgia; however, efficacy in controlling facial TNP or postherpetic neuralgia is unknown. A retrospective case series of patients who underwent subcutaneous placement of stimulating electrodes for treatment of V1 or V2 TNP secondary to herpetic infection or facial trauma is presented.

METHODS: Ten patients received implanted subcutaneous pulse generators and quadripolar electrodes for peripheral stimulation of the trigeminal nerve supraorbital or infraorbital branches. Long-term treatment results were determined by retrospective review of medical records (1998-2003) and by independent observers interviewing patients using a standard questionnaire. Surgical complication rate, preoperative symptom duration, degree of pain relief, preoperative and postoperative work status, postoperative changes in medication usage, and overall degree of therapy satisfaction were assessed. Mean follow-up was 26.6 ± 4.7 months.

RESULTS: Peripheral nerve stimulation provided at least 50% pain relief in 70% of patients with TNP or postherpetic neuralgia. Medication use declined in 70% of patients, and 80% indicated that they were mostly or completely satisfied with treatment overall. There were no treatment failures (< 50% pain relief and a lack of decrease in medication use) in the posttraumatic group, and two failures (50%) occurred in the postherpetic group. The complication rate requiring reoperation was 30%.

CONCLUSION: Peripheral nerve stimulation of the supraorbital or infraorbital branches of the trigeminal nerve is an effective method for relief of TNP after facial trauma or herpetic infection. A prospective trial using this novel approach to treat these disorders is thus warranted.

====================

Thank you Dr. Lawhern;

Do you know where the trials are going to take place? This is a pilot study, as is mention in the abstract so I have to assumed the Clinical trials will take place somewhere in the near future?

I can send Dr. Burcheil a note to ask what happened to clinical trials. It may take a few days to get an answer, if he does at all (the man is super busy). If you don't hear from me, ping me please with a reminder.

Regards, Red

I have a PNS, in fact I'm on my second one and it has saved my life. The first one was implanted in May 2008 and second one was put in November 2011.

The wires are implanted on the left side of my face, where the TN is, and the wires were placed directly over the branch above and below the eye.

The battery is in my chest and connects to the wires run through my neck.

I have a controller that has a magnetic wand that I place over the battery pack, which allows me to change the current which in turn reduces my pain. Its faster than medication and doesnt have the dopey feeling afterward.

please let me know if you have any questions

Jill