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Updated: Sep 8, 2025

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Trigeminal Rhizotomy Using Gyroscopic Radiosurgery: A Case Report.

Peter D Klassen1, Sai K Ivaturi2, Benjamin K Hendricks3

  • 1Neurosurgery, Bonifatius Hospital, Lingen, DEU.

Cureus
|June 16, 2022
PubMed
Summary

Trigeminal neuralgia (TN) patients can be treated with the ZAP-X radiosurgery system. This initial case shows reduced pain and medication needs after treatment for recurrent TN.

Keywords:
gyroscopicneuralgianovelposterior fossastereotactic radiosurgeryzap

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Area of Science:

  • Neurosurgery
  • Radiation Oncology

Background:

  • Trigeminal neuralgia (TN) is a common craniofacial pain syndrome characterized by severe, episodic lancinating pain.
  • Medical management failure necessitates interventional procedures, with stereotactic radiosurgery (SRS) being a frequent surgical choice.

Observation:

  • This study presents the first case of TN treatment using the ZAP-X gyroscopic radiosurgery system.
  • A 59-year-old male with multiple sclerosis and recurrent idiopathic TN, previously treated with SRS, underwent retreatment.

Findings:

  • The patient received 7500 cGy dose delivered via 100 isocentric 5 mm beams in the ZAP-X system.
  • At three months post-treatment, the patient reported a 45% reduction in visual analogue scale (VAS) pain scores and decreased medication reliance.

Implications:

  • This preliminary experience suggests the ZAP-X system is a feasible option for radiosurgical treatment of TN.
  • The ZAP-X system offers a cobalt-free, self-shielded alternative for managing this challenging pain condition.