Document Detail


Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia.
MedLine Citation:
PMID:  11147887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Stereotactic radiosurgery is an increasingly used and the least invasive surgical option for patients with trigeminal neuralgia. In this study, the authors investigate the clinical outcomes in patients treated with this procedure. METHODS: Independently acquired data from 220 patients with idiopathic trigeminal neuralgia who underwent gamma knife radiosurgery were reviewed. The median age was 70 years (range 26-92 years). Most patients had typical features of trigeminal neuralgia, although 16 (7.3%) described additional atypical features. One hundred thirty-five patients (61.4%) had previously undergone surgery and 80 (36.4%) had some degree of sensory disturbance related to the earlier surgery. Patients were followed for a maximum of 6.5 years (median 2 years). Complete or partial relief was achieved in 85.6% of patients at 1 year. Complete pain relief was achieved in 64.9% of patients at 6 months, 70.3% at 1 year, and 75.4% at 33 months. Patients with an atypical pain component had a lower rate of pain relief (p = 0.025). Because of recurrences, only 55.8% of patients had complete or partial pain relief at 5 years. The absence of preoperative sensory disturbance (p = 0.02) or previous surgery (p = 0.01) correlated with an increased proportion of patients who experienced complete or partial pain relief over time. Thirty patients (13.6%) reported pain recurrence 2 to 58 months after initial relief (median 15.4 months). Only 17 patients (10.2% at 2 years) developed new or increased subjective facial paresthesia or numbness, including one who developed deafferentation pain. CONCLUSIONS: Radiosurgery for idiopathic trigeminal neuralgia was safe and effective, and it provided benefit to a patient population with a high frequency of prior surgical intervention.
Authors:
S Maesawa; C Salame; J C Flickinger; S Pirris; D Kondziolka; L D Lunsford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  94     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-05     Completed Date:  2001-01-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurological Surgery, University of Pittsburgh, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Male
Middle Aged
Pain / physiopathology
Palliative Care
Postoperative Complications
Postoperative Period
Radiosurgery*
Stereotaxic Techniques*
Time Factors
Treatment Outcome
Trigeminal Neuralgia / physiopathology,  surgery*
Comments/Corrections
Comment In:
J Neurosurg. 2002 Jan;96(1):160-1   [PMID:  11794600 ]
J Neurosurg. 2001 Jun;94(6):1018-9   [PMID:  11409506 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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