Implantable Gasserian ganglion stimulation for refractory trigeminal neuropathic pain: systematic review of observational clinical evidence.

INTRODUCTION

Refractory trigeminal neuropathic pain, including classical trigeminal neuralgia (TN) and secondary etiologies, is a chronic neuropathic disorder characterized by recurrent, electric shock-like facial pain that can be disabling and resistant to conventional treatments. Electrical stimulation of the Gasserian ganglion through the foramen ovale has emerged as a minimally invasive technique capable of modulating nociceptive transmission.

OBJECTIVE

This systematic review aimed to assess the efficacy and safety of electrical stimulation of the Gasserian ganglion in patients with refractory trigeminal pain.

METHODS

A literature search across PubMed, Embase, BVS, and Cochrane identified six studies published between 1987 and 2024, including a total of 105 patients.

Results

Pain relief was achieved in 78.7% of cases, while 21.3% showed no improvement. Reported complications occurred in 39% of patients, mainly involving minor issues, with no permanent neurological deficits.

CONCLUSION

Electrical stimulation of the Gasserian ganglion may represent therapeutic option for refractory trigeminal neuropathic pain. The current evidence is limited by observational study designs, risk of bias, and heterogeneity across studies. While some reports suggest meaningful pain reduction and few serious complications, the available evidence remains low. Further prospective studies are required to establish the effectiveness and safety of this intervention.