title: Outcome of radiosurgery treatment with a linear accelerator in patients with trigeminal neuralgia.
abstract: BACKGROUND
  An overview of the effectiveness of radiosurgery in patients diagnosed with trigeminal neuralgia with an analysis of potential predictors of good outcome.
  
  
  METHODS
  All patients treated with linear accelerator radiosurgery between 2004 and 2011 were analysed. A dose of 60Gy dose was administered 1 to 2mm from the root entry zone with a maximum isodose of 20% delivered to the brainstem. Clinical results for pain control and any side effects were analysed at 12 and 36 months (BNI score).
  
  
  RESULTS
  The study included 71 patients (mean follow-up 50.5 months). Pain improvement at 12 months was observed in 68.11% of the total (28.98% with BNI score i-ii; 39.12% with BNI score iii) and at 36 months in 58.21% (23.88% BNI score i-ii; 34.32% BNI score iii). Average recovery time was 3.69 months and the relapse rate was 44.68%. Patients with typical pain displayed statistically significant differences in improvement rates at 12 and at 36 months (P<047 and P<.002). Onset of improvement was analysed using Kaplan-Meyer plots. Statistically significant differences were observed between patients with typical and atypical pain at 36 months (P<.012) in Kaplan-Meyer plots. Side effects were recorded in 15 patients (20.89%), including 9 cases of facial numbness (13.43%); only 2 cases were clinically relevant (2.98%).
  
  
  CONCLUSIONS
  According to our results, radiosurgery is an effective treatment for trigeminal neuralgia, with few side effects. Typical pain seems to be a good predictor of pain relief.
authors.affiliation: Servicio de Neurocirugía, Complejo Hospitalario de Jaén, Hospital Neurotraumatológico, Jaén, España. Electronic address: ncorderotous@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Cordero Tous
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Virgen de las Nieves, Hospital de Rehabilitación y Traumatología, Granada, España.
authors.forename: J de la
authors.initials: J
authors.lastname: Cruz Sabido
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Virgen de las Nieves, Hospital de Rehabilitación y Traumatología, Granada, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Román Cutillas
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Virgen de las Nieves, Hospital de Rehabilitación y Traumatología, Granada, España.
authors.forename: E J
authors.initials: EJ
authors.lastname: Saura Rojas
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Virgen de las Nieves, Hospital de Rehabilitación y Traumatología, Granada, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Jorques Infante
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Virgen de las Nieves, Hospital de Rehabilitación y Traumatología, Granada, España.
authors.forename: G
authors.initials: G
authors.lastname: Olivares Granados
mesh_terms: D000368:Aged; D001933:Brain Stem; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D010315:Particle Accelerators; D016634:Radiosurgery / Q000379:methods* / Q000706:statistics & numerical data; D012008:Recurrence; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000188:drug therapy / Q000532:radiotherapy*
keywords: Acelerador lineal; Adormecimiento facial; Dolor típico; Facial numbness; Linear accelerator; Neuralgia del trigémino; Neurocirugía; Neurosurgery; Radiocirugía; Radiosurgery; Trigeminal neuralgia; Typical pain