Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia

Han, Jung Ho; Kim, Dong Gyu; Chung, Hyun-Tai; Paek, Sun Ha; Kim, Yong Hwy; Kim, Chae-Yong; Kim, Jin Wook; Kim, Young-Hoon; Jeong, Sang Soon

doi:10.1016/j.ijrobp.2008.11.046

Cited by 51 publications

(25 citation statements)

References 26 publications

(47 reference statements)

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“…Han et al noted that despite an initial rate of pain relief of more than 90% after GKRS for idiopathic TN, 52% of patients experienced a recurrence between 2 and 56 months post-GKRS. 15 Numerous reports have detailed success with repeat GKRS for recurrent TN, especially in patients who demonstrate a good response after initial GKRS. More than 60% of patients undergoing repeat GKRS experience at least 50% improvement in pain.…”

Section: Discussionmentioning

confidence: 99%

“…After primary GKRS for TN, some degree of trigeminal dysfunction has been reported to occur in between 6% and 54% of patients. 6,15,27,34,38,39,41,46 In 11%-74% of these patients there is worsening of preexisting trigeminal disturbance or new onset of dysfunction following repeat radiosurgery for TN. 1,9,13,16,18,21,24,27,34,43,45 Most patients with TN typically report satisfactory pain relief without bothersome sensory dysfunction following the radiosurgical procedure.…”

Section: Trigeminal Sensory Dysfunction After Triple Gkrsmentioning

confidence: 99%

“…6,8,30,42 At a median of approximately 2 years, between 25% and 52% of these patients can develop recurrent TN. 15,27,46 Such patients have been found to benefit from repeat GKRS, with success rates of between 62% and 95% at a median 32-month follow-up. 1,9,13,16,18,19,24,34,36,45 In this report, we describe our experience in a small cohort of patients who ultimately underwent 3 GKRS procedures because of the recurrence of medically intractable pain.…”

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confidence: 99%

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The results of a third Gamma Knife procedure for recurrent trigeminal neuralgia

Tempel

Chivukula

Monaco

et al. 2015

JNS

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OBJECT Gamma Knife radiosurgery (GKRS) is the least invasive treatment option for medically refractory, intractable trigeminal neuralgia (TN) and is especially valuable for treating elderly, infirm patients or those on anticoagulation therapy. The authors reviewed pain outcomes and complications in TN patients who required 3 radiosurgical procedures for recurrent or persistent pain. METHODS A retrospective review of all patients who underwent 3 GKRS procedures for TN at 4 participating centers of the North American Gamma Knife Consortium from 1995 to 2012 was performed. The Barrow Neurological Institute (BNI) pain score was used to evaluate pain outcomes. RESULTS Seventeen patients were identified; 7 were male and 10 were female. The mean age at the time of last GKRS was 79.6 years (range 51.2–95.6 years). The TN was Type I in 16 patients and Type II in 1 patient. No patient suffered from multiple sclerosis. Eight patients (47.1%) reported initial complete pain relief (BNI Score I) following their third GKRS and 8 others (47.1%) experienced at least partial relief (BNI Scores II–IIIb). The average time to initial response was 2.9 months following the third GKRS. Although 3 patients (17.6%) developed new facial sensory dysfunction following primary GKRS and 2 patients (11.8%) experienced new or worsening sensory disturbance following the second GKRS, no patient sustained additional sensory disturbances after the third procedure. At a mean follow-up of 22.9 months following the third GKRS, 6 patients (35.3%) reported continued Score I complete pain relief, while 7 others (41.2%) reported pain improvement (BNI Scores II–IIIb). Four patients (23.5%) suffered recurrent TN following the third procedure at a mean interval of 19.1 months. CONCLUSIONS A third GKRS resulted in pain reduction with a low risk of additional complications in most patients with medically refractory and recurrent, intractable TN. In patients unsuitable for other microsurgical or percutaneous strategies, especially those receiving long-term oral anticoagulation or antiplatelet agents, GKRS repeated for a third time was a satisfactory, low risk option.

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Section: Discussionmentioning

confidence: 99%

Section: Trigeminal Sensory Dysfunction After Triple Gkrsmentioning

confidence: 99%

mentioning

confidence: 99%

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The results of a third Gamma Knife procedure for recurrent trigeminal neuralgia

Tempel

Chivukula

Monaco

et al. 2015

JNS

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“…It seems that clinical results are quite similar using either the proximal target (Brisman 2004;Cheuk, 2004;Dhople, 2007;Han, 2009;Huang, 2008;Kim, 2010;Little, 2008;Longhi, 2007;Matsuda, 2010Nicol, 2000;Pan, 2010;Park, 2011;Pollock, 2002;Rogers, 2000 Tawk;Verheul, 2010;Young, 1998) as well as the distal one (Dellaretti, 2008;Hayashi 2009;Massager, 2007a;Regis, 2009). Matsuda (Matsuda 2008) in a series of 100 patients reports better pain control and lesser morbidity in patients treated with a proximal compared with those treated with a distal target.…”

Section: Proximal Nerve Targetingmentioning

confidence: 93%

“…Han (Han, 2009), Sheehan (Sheehan, 2005), Regis (Regís, 2006) and Towk (Tawk, 2005) conversely described worse results in younger patients. In spite of these controversial results, the majority of authors have not found significant influence of the patient age in pain control (Aubuchon, 2010;Azar, 2009;Brisman, 2004;Dellaretti, 2008;Hayashi, 2009;Little, 2008;Longhi, 2007;Massager, 2007a;Park, 2011;Petit, 2003;Riesenburger, 2010;Rogers, 2000;Young, 1998).…”

Section: Clinical Variablesmentioning

confidence: 94%