Title

Gamma knife radiosurgery for recurrent trigeminal neuralgia.

Department

Neurosurgery; Radiation Oncology

Document Type

Article

Abstract

OBJECT: Pain may fail to respond or may recur after initial gamma knife radiosurgery (GKS) for trigeminal neuralgia (TN). The authors examined their experience with performing a second GKS procedure in these patients.

METHODS: Twenty-nine patients underwent repeated GKS for TN at our institution between March 1997 and March 2002. Questionnaires were mailed to patients to assess the degree of their pain relief and the extent of facial numbness. Nineteen patients responded. All patients underwent repeated GKS involving a single 4-mm isocenter directed at the trigeminal nerve as it exited the brainstem (mean maximum dose 23.2 Gy). At a mean follow up of 13.5 months after the second procedure, 10 patients (53%) were pain free and medication free. Four patients (21%) were pain free but elected to continue medication in reduced dose, and two patients (11%) had incomplete but satisfactory pain control and were still taking medication. There was new-onset facial numbness in eight patients (42%), rated as tolerable in all instances.

CONCLUSIONS: Patients with facial numbness had a greater likelihood of being pain free than those with no sensory loss. The authors observed no cases of corneal anesthesia, keratitis, or deafferentation pain.

Medical Subject Headings

Follow-Up Studies; Humans; Postoperative Complications; Radiosurgery; Recurrence; Reoperation; Surveys and Questionnaires; Treatment Outcome; Trigeminal Neuralgia

Publication Date

12-1-2002

Publication Title

Journal of neurosurgery

ISSN

0022-3085

Volume

97

Issue

5 Suppl

First Page

536

Last Page

538

PubMed ID

12507092

Digital Object Identifier (DOI)

10.3171/jns.2002.97.supplement

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