Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia: long-term outcome and complications.

Kostas N. Fountas, Joseph R. Smith, Gregory P. Lee, Patrick D. Jenkins, Rebecca R. Cantrell, W. Chris Sheils

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECT: Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors' institution. METHODS: One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study. Their ages were 41-82 years (mean 72.3 years). All patients underwent SRS with prescribed maximal radiation doses ranging from 70 to 85 Gy. Isocenters 1-3 were used and plugging was used selectively. The follow-up period was 12-72 months (mean 34.3 months). The patients were divided into 2 groups according to their history of previous surgery. RESULTS: The initial response rate in patients with no history of previous surgery was 92.9%; in those who had undergone previous surgery, the initial response rate was 85.7%. At the end of the 1st posttreatment year, an excellent outcome was achieved in 82.5% of patients who had not had previous surgery, and in 69.4% of those who had. The respective outcome rates for the 2nd posttreatment year were 78 and 63.5%, respectively. The most common complication was the development of persistent paresthesia, which occurred in 15.8% of patients with no previous surgery and 16.3% of those with previous surgery. CONCLUSIONS: Stereotactic radiosurgery with the GK is a safe and effective treatment option for patients with medically refractory idiopathic TN.

Original languageEnglish (US)
Pages (from-to)E8
JournalNeurosurgical focus
Volume23
Issue number6
DOIs
StatePublished - 2007

Fingerprint

Trigeminal Neuralgia
Radiosurgery
Therapeutics
Paresthesia
Retrospective Studies
Radiation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia : long-term outcome and complications. / Fountas, Kostas N.; Smith, Joseph R.; Lee, Gregory P.; Jenkins, Patrick D.; Cantrell, Rebecca R.; Sheils, W. Chris.

In: Neurosurgical focus, Vol. 23, No. 6, 2007, p. E8.

Research output: Contribution to journalArticle

Fountas, Kostas N. ; Smith, Joseph R. ; Lee, Gregory P. ; Jenkins, Patrick D. ; Cantrell, Rebecca R. ; Sheils, W. Chris. / Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia : long-term outcome and complications. In: Neurosurgical focus. 2007 ; Vol. 23, No. 6. pp. E8.
@article{3f3e629585144fa3b277e286228c5ef6,
title = "Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia: long-term outcome and complications.",
abstract = "OBJECT: Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors' institution. METHODS: One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study. Their ages were 41-82 years (mean 72.3 years). All patients underwent SRS with prescribed maximal radiation doses ranging from 70 to 85 Gy. Isocenters 1-3 were used and plugging was used selectively. The follow-up period was 12-72 months (mean 34.3 months). The patients were divided into 2 groups according to their history of previous surgery. RESULTS: The initial response rate in patients with no history of previous surgery was 92.9{\%}; in those who had undergone previous surgery, the initial response rate was 85.7{\%}. At the end of the 1st posttreatment year, an excellent outcome was achieved in 82.5{\%} of patients who had not had previous surgery, and in 69.4{\%} of those who had. The respective outcome rates for the 2nd posttreatment year were 78 and 63.5{\%}, respectively. The most common complication was the development of persistent paresthesia, which occurred in 15.8{\%} of patients with no previous surgery and 16.3{\%} of those with previous surgery. CONCLUSIONS: Stereotactic radiosurgery with the GK is a safe and effective treatment option for patients with medically refractory idiopathic TN.",
author = "Fountas, {Kostas N.} and Smith, {Joseph R.} and Lee, {Gregory P.} and Jenkins, {Patrick D.} and Cantrell, {Rebecca R.} and Sheils, {W. Chris}",
year = "2007",
doi = "10.3171/FOC-07/12/E9",
language = "English (US)",
volume = "23",
pages = "E8",
journal = "Neurosurgical Focus",
issn = "1092-0684",
publisher = "American Association of Neurological Surgeons",
number = "6",

}

TY - JOUR

T1 - Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia

T2 - long-term outcome and complications.

AU - Fountas, Kostas N.

AU - Smith, Joseph R.

AU - Lee, Gregory P.

AU - Jenkins, Patrick D.

AU - Cantrell, Rebecca R.

AU - Sheils, W. Chris

PY - 2007

Y1 - 2007

N2 - OBJECT: Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors' institution. METHODS: One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study. Their ages were 41-82 years (mean 72.3 years). All patients underwent SRS with prescribed maximal radiation doses ranging from 70 to 85 Gy. Isocenters 1-3 were used and plugging was used selectively. The follow-up period was 12-72 months (mean 34.3 months). The patients were divided into 2 groups according to their history of previous surgery. RESULTS: The initial response rate in patients with no history of previous surgery was 92.9%; in those who had undergone previous surgery, the initial response rate was 85.7%. At the end of the 1st posttreatment year, an excellent outcome was achieved in 82.5% of patients who had not had previous surgery, and in 69.4% of those who had. The respective outcome rates for the 2nd posttreatment year were 78 and 63.5%, respectively. The most common complication was the development of persistent paresthesia, which occurred in 15.8% of patients with no previous surgery and 16.3% of those with previous surgery. CONCLUSIONS: Stereotactic radiosurgery with the GK is a safe and effective treatment option for patients with medically refractory idiopathic TN.

AB - OBJECT: Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors' institution. METHODS: One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study. Their ages were 41-82 years (mean 72.3 years). All patients underwent SRS with prescribed maximal radiation doses ranging from 70 to 85 Gy. Isocenters 1-3 were used and plugging was used selectively. The follow-up period was 12-72 months (mean 34.3 months). The patients were divided into 2 groups according to their history of previous surgery. RESULTS: The initial response rate in patients with no history of previous surgery was 92.9%; in those who had undergone previous surgery, the initial response rate was 85.7%. At the end of the 1st posttreatment year, an excellent outcome was achieved in 82.5% of patients who had not had previous surgery, and in 69.4% of those who had. The respective outcome rates for the 2nd posttreatment year were 78 and 63.5%, respectively. The most common complication was the development of persistent paresthesia, which occurred in 15.8% of patients with no previous surgery and 16.3% of those with previous surgery. CONCLUSIONS: Stereotactic radiosurgery with the GK is a safe and effective treatment option for patients with medically refractory idiopathic TN.

UR - http://www.scopus.com/inward/record.url?scp=38849195572&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38849195572&partnerID=8YFLogxK

U2 - 10.3171/FOC-07/12/E9

DO - 10.3171/FOC-07/12/E9

M3 - Article

C2 - 18081485

AN - SCOPUS:38849195572

VL - 23

SP - E8

JO - Neurosurgical Focus

JF - Neurosurgical Focus

SN - 1092-0684

IS - 6

ER -