title: Gamma knife radiosurgery for trigeminal neuralgia: the Washington University initial experience.
abstract: Seventy-three patients were evaluated for the changes in pain relief, numbness and paresthesias after Gamma Knife radiosurgery to a maximum dose of 76-87 Gy for trigeminal neuralgia. Patients experienced pain relief as follows: 59% attained complete pain relief without prior surgery (33% with prior surgery); 25% achieved > or = 50% pain reduction (28% with prior surgery); 11% of surgery patients obtained minor pain relief, and 16% of patients without surgery had no relief (28% with prior surgery). Level of pain decreased rapidly within 6 weeks after radiosurgery. Numbness/paresthesias developed slowly over the first 12-15 months. Bothersome levels were experienced by 15% of the patients without prior surgery (22% with prior surgery). Comparison of the occurrence of numbness/paresthesias, with respect to prior surgery, was not statistically significant. Only 2% of all patients had persistently bothersome side effects. In conclusion, radiosurgery is an effective treatment of trigeminal neuralgia, especially for those patients not having prior surgery.
authors.affiliation: Washington University School of Medicine, St. Louis, MO, USA. Drzymala@radonc.wustl.edu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drzymala
authors.forename: Robert S
authors.initials: RS
authors.lastname: Malyapa
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Dowling
authors.forename: Keith M
authors.initials: KM
authors.lastname: Rich
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Simpson
authors.forename: David B
authors.initials: DB
authors.lastname: Mansur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008923:Missouri; D010147:Pain Measurement; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D016634:Radiosurgery / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*