Document Detail


Linear accelerator radiosurgery for trigeminal neuralgia.
MedLine Citation:
PMID:  16331167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Gregory M Richards; Kristin A Bradley; Wolfgang A Tom?; S?ren M Bentzen; Daniel K Resnick; Minesh P Mehta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  57     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-06     Completed Date:  2006-05-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1193-200; discussion 1193-200     Citation Subset:  IM    
Affiliation:
Department of Human Oncology, University of Wisconsin Medical School, K4/B29 Clinical Sciences Center, Madison, Wisconsin 53792, USA. richards@humonc.wisc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Face / radiation effects
Female
Follow-Up Studies
Humans
Hypesthesia / etiology
Male
Middle Aged
Palliative Care*
Particle Accelerators*
Radiosurgery* / adverse effects
Recurrence
Retrospective Studies
Stereotaxic Techniques
Time Factors
Treatment Outcome
Trigeminal Neuralgia / physiopathology,  surgery*

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


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