title: Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia.
abstract: OBJECTIVE
  There are various surgical treatment alternatives for trigeminal neuralgia (TN), but there is no single scale that can be used uniformly to assess and compare one type of intervention with the others. In this study the objectives were to determine factors associated with pain control, pain-free survival, residual pain, and recurrence after gamma knife surgery (GKS) treatment for TN, and to correlate the patients' self-reported quality of life (QOL) and satisfaction with the aforementioned factors.
  
  
  METHODS
  Between the years 2000 and 2004, the authors treated 81 patients with medically refractory TN by using GKS. Fifty-two patients responded to a questionnaire regarding pain control, activities of daily living, QOL, and patient satisfaction. The median follow-up duration was 16.5 months. Twenty-two patients (42.3%) had complete pain relief, 14 (26.9%) had partial but satisfactory pain relief, and in 16 patients (30.8%) the treatment failed. Seven patients (13.5%) reported a recurrence during the follow-up period, and 25 (48.1%) reported a significant (> 50%) decrease in their pain within the 1st month posttreatment. The mean decrease in the total dose of pain medication was 75%. Patients' self-reported QOL scores improved 90% and the overall patient satisfaction score was 80%.
  
  
  CONCLUSIONS
  The authors found that GKS is a minimally invasive and effective procedure that yields a favorable outcome for patients with recurrent or refractory TN. It may also be offered as a first-line surgical modality for any patients with TN who are unsuited or unwilling to undergo microvascular decompression.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130-3932, USA. ananda@lsuhsc.edusswamy@lsuhsc.edu
authors.forename: Ajay
authors.initials: A
authors.lastname: Jawahar
authors.forename: Rishi
authors.initials: R
authors.lastname: Wadhwa
authors.forename: Caglar
authors.initials: C
authors.lastname: Berk
authors.forename: Gloria
authors.initials: G
authors.lastname: Caldito
authors.forename: Allyson
authors.initials: A
authors.lastname: DeLaune
authors.forename: Federico
authors.initials: F
authors.lastname: Ampil
authors.forename: Brian
authors.initials: B
authors.lastname: Willis
authors.forename: Donald
authors.initials: D
authors.lastname: Smith
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D016634:Radiosurgery / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*