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$Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain$

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain

Published on: May 10, 2017

Repeat Radiosurgery for Trigeminal Neuralgia.

Corbin A Helis¹, John T Lucas, J Daniel Bourland

¹*Departments of Neurosurgery and ‡Radiation Oncology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

|July 28, 2015

Summary

This summary is machine-generated.

Repeat Gamma Knife radiosurgery (GKRS) effectively treats recurrent trigeminal neuralgia pain. Patients experiencing facial numbness and positive pain response after initial GKRS show better outcomes with repeat treatment.

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Area of Science:

Neurosurgery
Neurology
Radiation Oncology

Background:

Recurrent trigeminal neuralgia (TN) pain often necessitates repeat treatments.
Gamma Knife radiosurgery (GKRS) is an established option for recurrent TN, with reported success rates ranging from 68% to 95%.

Purpose of the Study:

To evaluate outcomes of repeat Gamma Knife radiosurgery (GKRS) for trigeminal neuralgia (TN).
To identify predictive factors for successful repeat GKRS in TN patients.

Main Methods:

Retrospective cohort study of 152 patients undergoing repeat GKRS for TN between 1999 and 2013.
Long-term follow-up data collected via chart review and telephone interviews.

Main Results:

84% of patients achieved Barrow Neurological Institute (BNI) IIIb pain relief; 46% achieved BNI I.
1-, 3-, and 5-year rates for BNI I pain relief were 63%, 50%, and 37%, respectively.
Facial numbness post-first GKRS and positive pain response to initial GKRS predicted better outcomes.

Conclusions:

Repeat Gamma Knife radiosurgery (GKRS) is effective for recurrent trigeminal neuralgia (TN).
Predictive factors for successful repeat GKRS include prior facial numbness and positive pain response to the first GKRS.