Instant and early efficacy of gamma knife treatment on trigeminal neuralgia

Abstract

OBJECTIVE Trigeminal neuralgia (TN) is a common craniofacial pain syndrome manifested by the episodes of severe lancinating pain along the sensory region of the trigeminal nerve. Vascular compression theory has been postulated as the main cause of TN in the root entry zone of the trigeminal nerve. Microvascular decompression surgery is the most effective surgical option for the treatment of TN. Gamma knife surgery (GKS) is a minimally invasive treatment for drug-resistant trigeminal neuralgia (TN). We aimed to investigate the instant and early pain relief in 12 consecutive patients. METHODS This clinical study was conducted at the Department of Radiation Oncology, Medipol University, Turkey. The patient population consisted of 12 consecutive patients having medically refractory TN, with a median age of 60.5 (ranging from 50 to 77 years). Patients underwent GKS between March and January 2016, using the Gamma Knife Perfexion Model. A single 4 mm isocenter was positioned in the cisternal portion of the trigeminal nerve, and the mean maximum dose of 65 Gy (60-70 Gy) was delivered. RESULTS Satisfactory pain relief without any major complications was evident in all patients. The pain relief started after 1 hour to 3 days following the gamma knife procedure. CONCLUSION As a novel contribution to the relevant literature, instant and early pain relief was evident in all patients. In this context, a randomized prospective clinical trial with a larger patient population is necessary to optimize the instant and early efficacy of GKS in the treatment of TN.