Outcome for patients with essential trigeminal neuralgia treated with linear accelerator stereotactic radiosurgery.

Abstract

BACKGROUND:

Stereotactic radiosurgery (SRS) is one option for treatment of trigeminal neuralgia, after unsuccessful conservative approaches.

OBJECTIVES:

The objective of this study was to retrospectively evaluate our institutional results in the management of patients with idiopathic trigeminal neuralgia treated with linear accelerator SRS.

METHODS:

Fifty-two patients were treated between January 1998 and December 2009 and were followed for more than 6 months (median: 26.6 months). Forty-seven patients (90%) had undergone previous surgery before SRS. The target dose ranged from 50 to 80 Gy.

RESULTS:

After SRS, 9 patients presented complete remission of the pain, and 21 were pain free but still under medication. Eleven patients reported a relief of more than 50% in crisis frequency. In 9 patients, no significant improvements were seen, and 2 presented an exacerbation of the pain. After an average period of 20 months, 15 patients reported pain recurrence. Results were better in patients older than 60 years (p = 0.019). Nineteen patients presented facial numbness after SRS, with a trend toward favorable treatment response (p = 0.06).

CONCLUSION:

SRS is an effective alternative to the treatment of essential trigeminal neuralgia, with long-lasting pain relief in more than 50% of the patients. Better results were seen with patients aged more than 60 years.

• Authors: Marcos Antonio Dos Santos, José Bustos Pérez de Salcedo, José Angel Gutiérrez Diaz, Gorka Nagore, Felipe A Calvo, José Samblás, Hugo Marsiglia, Kita Sallabanda
• Journal: Stereotactic and functional neurosurgery (Stereotact Funct Neurosurg) Vol. 89 Issue 4 Pg. 220-5 ( 2011) ISSN: 1423-0372 [Electronic] Switzerland
• PMID: 21613807 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Topics

• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prognosis
• Radiosurgery (instrumentation)
• Retrospective Studies
• Treatment Outcome
• Trigeminal Neuralgia (surgery)