Radiosurgery for trigeminal neuralgia helpful.
Microvascular decompression is the procedure with the best track record for relieving pain due to trigeminal neuralgia. However, the surgery carries a risk of rare but serious complications, including brain stem infarction, cerebellar edema and hematoma, and hydrocephalus. Further, recovery often requires a stay in the intensive care unit.
Of 136 patients with a median age 68 years who underwent radiosurgery with the gamma knife at the University of Virginia, Charlottesville, 70% reported a significant diminution of pain up to 3 years later, said Dr. Sheehan of the university.
This series included 122 patients with typical trigeminal neuralgia, 3 whose TN took an atypical form, 4 with facial pain associated with multiple sclerosis, and 7 whose TN was associated with a cavernous sinus tumor. The median time elapsed from diagnosis to the gamma knife procedure was 72 months.
One year after surgery, 90% of the patients reported significant pain relief, and 47% had no pain. At 2 years, those numbers had dropped to 77% and 45%, respectively, and at 3 years, to 70% and 34%, respectively.
These findings are comparable with those of other studies by different investigators, who reported pain-free outcomes of 40%-50% and an overall 70% incidence of pain relief within the first few years after surgery, Dr. Sheehan said.
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|Publication:||Internal Medicine News|
|Article Type:||Brief Article|
|Date:||Mar 1, 2005|
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