Linear accelerator radiosurgery for trigeminal neuralgia

Gregory M. Richards, Kristin A. Bradley, Wolfgang A. Tomé, Søren M. Bentzen, Daniel K. Resnick, Minesh P. Mehta

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

OBJECTIVE: To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. METHODS: Twenty-eight patients with medication refractory idiopathic trigeminal neuralgia were treated with a single fraction of 80 Gy to the trigeminal nerve root. For treatment delivery, a 4-mm collimator and a 7-arc technique were delivered using a stereotactic floor stand system with an isocenter stability of 0.2 ± 0.1 mm to minimize dose to the brainstem. Treatment delivery time was approximately 55 minutes. RESULTS: With a median follow-up of 12 months (range, 1-40 mo), 57% of patients achieved complete pain relief and 75% (exact 95% confidence interval, 55 to 89%) had their pain reduced to 3 or less on a 10-point pain scale. Median time to pain relief was 1 month. Four patients did not respond to treatment. The actuarial mean time to pain recurrence in responders was 14 months, and the actuarial mean response duration in major to complete responders was 16 months. Women had significantly longer mean time to pain recurrence than men (16 versus 7 months; P = 0.05). Three patients reported new mild facial numbness after radiosurgery and one patient developed neurotrophic keratopathy. CONCLUSION: Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.

Original languageEnglish (US)
Pages (from-to)1193-1199
Number of pages7
JournalNeurosurgery
Volume57
Issue number6
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

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Keywords

  • Facial pain
  • Linear accelerator
  • Radiosurgery
  • Trigeminal neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Richards, G. M., Bradley, K. A., Tomé, W. A., Bentzen, S. M., Resnick, D. K., & Mehta, M. P. (2005). Linear accelerator radiosurgery for trigeminal neuralgia. Neurosurgery, 57(6), 1193-1199. https://doi.org/10.1227/01.NEU.0000186015.01179.70