Traitement des douleurs réfractaires de la face par la stimulation magnétique transcrânienne répétitive (SMTr) : étude ouverte sur une année

We report our experience of the use of repetitive transcranial magnetic stimulation (rTMS) treatment of severe and refractory chronic facial pain. The aim of this study is to evaluate the efficiency of rTMS in this indication and also to determine the modalities of follow-up and long-term treatment. Thirteen patients suffering from refractory facial pain were included (seven trigeminal neuralgias, four cluster headaches and two chronic post-shingles pain): the VAS of permanent pain was evaluated on average at 5.9/10 and during crises at 9.2/10. The course of rTMS treatment resulted in a decrease of permanent pain, evaluated at day 90 at 2.5/10 (disappearance of facial pain in four patients); disappearance of the crises in 53.1% and net decrease in 23.1% of the patients. For 38.5% of the patients, the spacing out of sessions results in a lesser relief of pain. In responsive patients, this technique appears to be an interesting tool offering a cumulative analgesic effect by the repetition of sessions.