title: Repeat gamma knife radiosurgery for trigeminal neuralgia.
abstract: BACKGROUND
  Although gamma knife radiosurgery (GKRS) has been shown to be safe and effective for the treatment of trigeminal neuralgia (TN), there are few studies that report the results of a second GKRS.
  
  
  METHODS
  Between May 22, 1998 and April 1, 2003, we treated 335 primary TN patients with GKRS. All received a maximum dose of 75 Gy to the cisternal trigeminal nerve. 45 patients with recurrent or persistent TN were treated with a maximum dose of 40 Gy at a second GKRS and were available for at least 6 months of follow-up.
  
  
  RESULTS
  Final pain relief (mean of 15 months after second GKRS) was 50% or greater in 28 of the 45 patients (62.2%). Patients who had no neurosurgical procedure prior to their first GKRS were more likely to have pain relief of 50% or greater following the second GKRS (p = 0.042). Significant new dysesthesias (score greater than 5 on a scale of 0-10) developed in 2 patients (4.4%).
  
  
  CONCLUSIONS
  Repeat GKRS has a good chance of relieving TN pain without complications and is more likely to relieve pain in those who did not have any procedure prior to their first GKRS.
authors.affiliation: Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, Columbia Presbyterian Medical Center, New York, NY, USA. rb36@columbia.edu
authors.forename: Ronald
authors.initials: R
authors.lastname: Brisman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016634:Radiosurgery; D012086:Reoperation; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*