Document Detail

Repeated Gamma Knife surgery for refractory trigeminal neuralgia.
MedLine Citation:
PMID:  18503339     Owner:  NLM     Status:  MEDLINE    
OBJECT: Repeated Gamma Knife surgery (GKS) for trigeminal neuralgia (TN) is an acceptable method for refractory cases but not well established in terms of dose effect and nerve tolerance. The authors report their experience in 28 patients over 3.5 years of follow up. METHODS: Between 1999 and 2004, a total of 28 patients with recurrent or residual TN underwent repeated GKS. The median follow-up periods were 52 and 43 months after the first and repeated procedures, respectively. The entry zone of the trigeminal nerve was targeted using a 4-mm collimator and treated with 40 to 76 Gy as maximal dose. Additive doses ranged between 110 and 152 Gy. The median duration of symptoms was 4.86 years. There were 12 women (46%) and 16 men (54%). At the last evaluation, a total of 19 patients (68%) reported pain relief. Of these patients, 13 were no longer taking pain medications. Significant recurrent or residual pain was noted in nine patients after a median follow up of 12 months (range 6-48 months). New onset of facial numbness was noted in 10 patients. An additive dose above 115 Gy was found to be associated with facial numbness and nonfacial numbness (p = 0.047). No definite additive dose correlation with pain relief was noted (p = 0.23). CONCLUSIONS: Repeated GKS established durable pain relief in a majority of patients, and a higher additive dose (> 115 Gy) tended to cause facial numbness. However, a prospective trial is needed to fully assess the efficacy and late complications of GKS.
Chuan-Fu Huang; Jim-Chao Chuang; Hsien-Tang Tu; Long-Yau Lin
Related Documents :
25211359 - Intraoperative corneal thickness monitoring during corneal collagen cross-linking with ...
18671629 - Clinical and neuroimaging outcome of cerebral arteriovenous malformations after gamma k...
12353439 - Incidence of post-tonsillectomy hemorrhage in children and adults: a study of 4,848 pat...
20919849 - Severe phenylephrine-associated hemorrhage in five aged horses.
7709409 - Impact of thalamic hematoma on six-month mortality and motor and cognitive functional o...
12776899 - Radiosurgery for the control of glomus jugulare tumours.
7023889 - Results of treatment for rectal prolapse and fecal incontinence.
7932419 - Intravenous gamma globulin as first line therapy in polymyositis and dermatomyositis: a...
22143739 - Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. a crossover...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  105 Suppl     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2009-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-102     Citation Subset:  AIM; IM    
Department of Neurosurgery, Chung-Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cohort Studies
Magnetic Resonance Imaging
Middle Aged
Pain, Intractable / etiology,  pathology,  prevention & control*
Radiotherapy Dosage
Retrospective Studies
Treatment Outcome
Trigeminal Neuralgia / complications,  pathology,  surgery*

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

Previous Document:  Volumetric follow up of brain metastases: a useful method to evaluate treatment outcome and predict ...
Next Document:  Radiosurgery for trigeminal neuralgia: is sensory disturbance required for pain relief?