Gamma Knife radiosurgery for the treatment of trigeminal neuralgia: A single center-experience

Neurocirugia (Astur : Engl Ed). 2024 Apr 18:S2529-8496(24)00020-0. doi: 10.1016/j.neucie.2024.04.001. Online ahead of print.

Abstract

Introduction and objectives: We aimed to assess the outcomes of patients with trigeminal neuralgia (TGN) who underwent Gamma Knife radiosurgery (GKRS).

Materials and methods: Fifty-three patients with typical TGN underwent GKRS from May 2012 until December 2022. Among these patients, 45 patients who were follow-up for at least 12 months were included in the study. A mean dose of 87.5 Gy (range, 80-90) was administered to the trigeminal nerve. Postoperatively, outcome was considered excellent if the patient was pain- and medication-free.

Results: The mean symtpom duration was 9.53 years, and the mean patient age was 59.8 years (range, 34-85). The mean follow-up period was 46.8 months (range, 12-127 months). 46.7% of patients had a history of previous surgical interventions. A single nerve division was affected in 14 patients (31.1%), and multiple divisions were affected in 31 patients (68.9%). The rate of initial pain relief was 80%. Hypoesthesia in the area of trigeminal nerve developed in 30 (66.7%). Twenty patients (44.4%) exhibited excellent results within 72.4 months. Recurrence occurred in 11 patients (24.4%) with 27.6 months.

Conclusions: Our results suggest that GKRS is a safe and effective procedure. Thus, it is an attractive first- and second-line treatment choice for TGN.

Keywords: Gamma Knife; Gamma-Knife; Neuralgia del trigémino; Outcome; Radiocirugía; Radiosurgery; Resultado; Trigeminal neuralgia.