Yonsei Med J.  2020 Feb;61(2):111-119. 10.3349/ymj.2020.61.2.111.

Gamma Knife Radiosurgery on the Trigeminal Root Entry Zone for Idiopathic Trigeminal Neuralgia: Results and a Review of the Literature

• Park SH
• Chang JW

• KMID: 2468485
• DOI: http://doi.org/10.3349/ymj.2020.61.2.111

Abstract

Trigeminal neuralgia (TN) is a chronic disorder of the trigeminal nerve characterized by repeated electrical shock-like sensations on one side of the face. It can cause severe pain in the face and disrupt or impair quality of life in patients. Options for the management of TN consist of pharmacological and surgical treatments, including Gamma Knife radiosurgery (GKRS). GKRS has been used for TN for a long time because of its low rate of complications and high success rate. Moreover, GKRS can be of use for drug-resistant TN patients who are poor surgical candidates due to medical comorbidities, patients of older age, or patients who refuse invasive therapy. We reviewed the rationale, effects, safety, and current treatment policies of GKRS for TN in view of our institution's results and a review of the literature to date.

Keyword

Gamma Knife radiosurgery; trigeminal neuralgia; facial pain

MeSH Terms

Comorbidity
Facial Pain
Humans
Quality of Life
Radiosurgery*
Sensation
Trigeminal Nerve
Trigeminal Neuralgia*

Figure

• 

  Fig. 1 Flow chart for patient inclusion. TN, trigeminal neuralgia; GKRS, Gamma Knife radiosurgery; MS, multiple sclerosis.

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  Fig. 2 Predicted pain relief maintenance period after Gamma Knife radiosurgery. Solid line represents predicted pain relief maintenance period and dotted line represents 95% confidence interval.

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  Fig. 3 Flow chart for inclusion of studies analyzing pain relief, complication, and recurrence rates.

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  Fig. 4 Forest plot of pain relief rates in 19 studies. Confidence intervals were calculated at a confidence level of 95% for a single proportion.

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  Fig. 5 Forest plot of complication rates in 19 studies. Confidence intervals were calculated at a confidence level of 95% for a single proportion.

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  Fig. 6 Targets used in Gamma Knife radiosurgery for trigeminal neuralgia. Retrogasserian area (A) and trigeminal root entry zone (B).

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