Document Detail


CyberKnife radiosurgical rhizotomy for the treatment of atypical trigeminal nerve pain.
MedLine Citation:
PMID:  18081486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Patients with atypical trigeminal neuralgia (TN) have unilateral pain in the trigeminal distribution that is dull, aching, or burning in nature and is constant or nearly constant. Studies of most radiosurgical and surgical series have shown lower response rates in patients with atypical TN. This study represents the first report of the treatment of atypical TN with frameless CyberKnife stereotactic radiosurgery (SRS). METHODS: Between 2002 and 2007, 7 patients that satisfied the criteria for atypical TN and underwent SRS were included in our study. A 6-8-mm segment of the trigeminal nerve was targeted, excluding the proximal 3 mm at the brainstem. All patients were treated in a single session with a median maximum dose of 78 Gy and a median marginal dose of 64 Gy. RESULTS: Outcomes in 7 patients with a mean age of 61.6 years and a median follow-up of 20 months are reported. Following SRS, 4 patients had complete pain relief, 2 had minimal pain relief with some decrease in the intensity of their pain, and 1 patient experienced no pain relief. Pain relief was reported within 1 week of SRS in 4 patients and at 4 months in 2 patients. After a median follow-up of 28 months, pain did not recur in any of the 4 patients who had reported complete pain relief. Complications after SRS included bothersome numbness in 3 patients and significant dysesthesias in 1 patient. CONCLUSIONS: The authors have previously reported a 90% rate of excellent pain relief in patients with classic TN treated with CyberKnife SRS. Compared with patients with classic TN, patients with atypical TN have a lower rate of pain relief. Nevertheless, the nearly 60% rate of success after SRS achieved in this study is still comparable to or better than results achieved with any other treatment modality for atypical TN.
Authors:
Chirag G Patil; Anand Veeravagu; Regina S Bower; Gordon Li; Steven D Chang; Michael Lim; John R Adler
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgical focus     Volume:  23     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2007  
Date Detail:
Created Date:  2007-12-17     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California 94305-5327, USA. chiragpatil@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Middle Aged
Radiosurgery / methods*
Radiotherapy Dosage
Retrospective Studies
Rhizotomy / methods*
Treatment Outcome
Trigeminal Neuralgia / surgery*

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


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