Clinical outcomes of 114 patients who underwent Gamma-knife radiosurgery for medically refractory idiopathic trigeminal neuralgia

Wang, Wei; Liu, Yi; Zhong, Qi; Mao, Biming

doi:10.1016/j.jocn.2011.03.020

Cited by 17 publications

(9 citation statements)

References 16 publications

(22 reference statements)

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“…GKRS can be given using one or two isocenters[ 89 ] and targeting radiosurgery posteriorly at dorsal REZ,[ 90 ] or anteriorly in retrogasserian zone. [ 91 ] 80 Gy,[ 90 ] 85 Gy,[ 92 ] and 90 Gy can be used.…”

Section: Gamma Knife Radiosurgerymentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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Section: Gamma Knife Radiosurgerymentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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“…Our results (higher rate of trigeminal dysfunction without significantly increased pain relief rate) were similar to some of previous studies that increased irradiation length of the nerve. [2,4,5,20] Analogously, based on the results of Marshall K's study, [8] patients with shorter length of trigeminal nerve in prepontine cistern could have better outcomes during follow up. Interestingly, one study reported that greater brainstem exposure volumes and lower trigeminal nerve treatment volume might result in improved pain relief without a significant difference in trigeminal nerve toxicity.…”

Section: Discussionmentioning

confidence: 99%

Effect of radiation dose on the outcomes of gamma knife treatment for trigeminal neuralgia: A multi-factor analysis

Zhang

et al. 2014

Neurol India

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Our limited results suggested that a higher integrated dose might increase the incidence of trigeminal nerve toxicity with no significant benefits in pain relief when the maximal doses were within 75-90 Gy. The protocol for increasing radiation variables such as longer nerve exposure length and higher maximal dose is not recommended as a routine approach and more randomized studies with large number of cases would be required to verify the best treatment strategy of gamma knife radiosurgery for TN.

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“…There is a delay between the procedure and pain control, and patients may need to wait several weeks or months for complete pain relief, but 55−97% of patients will achieve satisfactory pain relief. 24 Unfortunately, the recurrence of pain is common, and about 52% are pain free after 3 years. 22 Common complications involve delayed facial numbness 21 and troublesome sensory loss and paraesthesias.…”

Section: Intracranial Operationsmentioning

confidence: 99%

Pain part 7: trigeminal neuralgia

Jurge¹

2016

Dent Update

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Trigeminal neuralgia (TN) is also known as 'tic douloureux' (in French, 'painful twitch'). It is a rare chronic facial pain syndrome, characterized by severe, brief, stabbing, 'electric shock-like 'recurrent pain attacks felt in one or more divisions of trigeminal nerve innervation areas. So intense is the elicited pain that TN has a significant effect on a sufferer's quality of life, rendering many patients unable to consider a future with the ongoing threat of recurrent pain. The aim of this article is to discuss the diagnosis and management of this disabling facial pain condition. CPD/Clinical Relevance: As general medical practitioners may struggle differentiating TN from toothache, primary care dentists have an important role in excluding odontogenic cause of pain, diagnosing TN and referring patients to a facial pain clinic for further investigations and multidisciplinary team management.

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Clinical outcomes of 114 patients who underwent Gamma-knife radiosurgery for medically refractory idiopathic trigeminal neuralgia

Cited by 17 publications

References 16 publications

Trigeminal neuralgia

Trigeminal neuralgia

Effect of radiation dose on the outcomes of gamma knife treatment for trigeminal neuralgia: A multi-factor analysis

Pain part 7: trigeminal neuralgia

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