Gamma knife radiosurgery for trigeminal neuralgia: the Washington University initial experience.
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.
Drzymala
Robert E
RE
Washington University School of Medicine, St. Louis, MO, USA. Drzymala@radonc.wustl.edu
Malyapa
Robert S
RS
Dowling
Joshua L
JL
Rich
Keith M
KM
Simpson
Joseph R
JR
Mansur
David B
DB
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*