Advertisement

Gamma Knife Radiosurgery for Trigeminal Neuralgia

  • José A. Peñagarícano
Chapter

Abstract

The treatment of medically refractory trigeminal neuralgia with radiosurgery technique was reported by Leksell in 1971. Multiple publications, some with hundreds of patients, have reported on the efficacy of radiosurgery in medically refractory cases of trigeminal neuralgia. The main advantages of radiosurgery over other invasive procedures are minimal invasiveness and low risk of complications. Although today the standard prescribed dose is between 80 and 90 Gy, there is variability across the literature. Similarly, there is some variation in the placement of the isocenter. The goal of the radiosurgeon is to find a balance between the success of the procedure and the risk of the patient in developing toxicity.

Keywords

Radiosurgery Trigeminal neuralgia Gamma knife Stereotactic technique Long-term outcomes Recurrence 

References

  1. 1.
    Leksell L. Stereotaxic radiosurgery in trigeminal neuralgia. Acta Chir Scand. 1971;137(4):311–4.PubMedGoogle Scholar
  2. 2.
    Kondziolka D, Zorro O, Lobato-Polo J, Kano H, Flannery T, Flickinger J, Lunsford L. Gamma Knife stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg. 2010;112(4):758–65.CrossRefPubMedGoogle Scholar
  3. 3.
    Rogers CL, Shetter AG, Fiedler JA, et al. Gamma Knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys. 2000;47:1013–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Linskey M, Ratanatharathorn V, Penagaricano J. A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia. J Neurosurg. 2008;109(Suppl 2):190–72.Google Scholar
  5. 5.
    Martinez Moreno N, Gutierrez-Sarraga J, Rey-Portoles G, Jimenez-Huete A, Martinez Alvarez R. Long-term outcomes in the treatment of classical trigeminal neuralgia by Gamma Knife radiosurgery: a retrospective study in patients with minimum 2-year follow-up. Neurosurgery. 2016;79(6):879–88.CrossRefPubMedGoogle Scholar
  6. 6.
    Kotecha R, Kotecha R, Modugula S, Murphy E, Jones M, Kotecha R, Reddy C, Suh J, Barnett G, Neyman G, Machado A, Nagel S, Chao S. Trigeminal neuralgia treated with stereotactic radiosurgery: the effect of dose escalation on pain control and treatment outcomes. Int J Radiat Oncol Biol Phys. 2016;96(1):142–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Lorenzoni JG, Massager N, David P, Devriendt D, Desmedt F, Brotchi J, Levivier M. Neurovascular compression anatomy and pain outcome in patients with classical trigeminal neuralgia treated by radiosurgery. Neurosurgery. 2008;62(2):368–75.CrossRefPubMedGoogle Scholar
  8. 8.
    Massager N, Lorenzoni JG, Devriendt D, Desmedt F, Brotchi J, Levivier M. Gamma Knife surgery for idiopathic trigeminal neuralgia performed using a far-anterior cisternal target and a high dose of radiation. J Neurosurg. 2004;100(4):597–605.CrossRefPubMedGoogle Scholar
  9. 9.
    Regis J, Arkha Y, Yomo S, Murata N, Roussel P, Donnet A, Peragut JC. Radiosurgery in trigeminal neuralgia: long-term results and the influence of operative nuances. Neurochirurgie. 2009;55(2):213–22.CrossRefPubMedGoogle Scholar
  10. 10.
    Kondziolka D, Lunsford LD, Flickinger JC. Stereotactic radiosurgery for the treatment of trigeminal neuralgia. Clin J Pain. 2002;18(1):42–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Han J, Dg K, Chung HT, Paek SH, Kim YH, Cy K, Kim JW, Kim YH, Jeong SS. Long-term outcome of Gamma Knife radiosurgery for treatment of typical trigeminal neuralgia. Int J Radiat Oncol Biol Phys. 2009;75(3):822–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Huang CF, Tu HT, Liu WS, Chiou SY, Lin LY. Gamma Knife surgery used as primary and repeated treatment for idiopathic trigeminal neuralgia. J Neurosurg. 2008;109(Suppl):179–84.PubMedGoogle Scholar
  13. 13.
    Longhi M, Rizzo P, Nicolato A, Foroni R, Reggio M, Gerosa M. Gamma Knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters-part I: idiopathic trigeminal neuralgia. Neurosurgery. 2007;61(6):1254–60.CrossRefPubMedGoogle Scholar
  14. 14.
    Matsuda S, Serizawa T, Nagano O, Ono J. Comparison of the results of 2 targeting methods in Gamma Knife surgery for trigeminal neuralgia. J Neurosurg. 2008;109(Suppl):185–9.PubMedGoogle Scholar
  15. 15.
    Kondziolka D, Lunsford LD, Flickinger JC, Young RF, Vermeulen S, Duma CM, Jacques DB, Rand RW, Regis J, Peragut JC, Manera L, Epsatein MH, Lindquist C. Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit. J Neurosurg. 1996;84(6):940–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Cheuk AV, Chin LS, Petitt JH, Herman JM, Fang HB, Regine WF. Gamma Knife surgery for trigeminal neuralgia: outcome, imaging, and brain stem correlates. Int J Radiat Ocol Biol Phys. 2004;60(2):537–41.CrossRefGoogle Scholar
  17. 17.
    Maesawa S, Salame C, Flickinger JC, Pirris S, Kondziolka D, Lunsford LD. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg. 2001;94(1):14–20.CrossRefPubMedGoogle Scholar
  18. 18.
    Park K, Kondziolka D, Berkowitz O, Kano H, Novotny J, Niranjan A, Flickinger J, Lunsford L. Repeat Gamma Knife radiosurgery for trigeminal neuralgia. Neurosurgery. 2012;70:295–305.CrossRefPubMedGoogle Scholar
  19. 19.
    Aubuchon AC, Chan MD, Lovat JF, Balamucki CJ, Ellis TL, Tatter SB, McMullen KP, Munley MT, Deguzman AF, Ekstrand KE, Bourland JD, Shaw EG. Repeat Gamma Knife radiosurgery for trigeminal neuralgia. Int J Radiat Oncol Biol Phys. 2011;81(4):1059–65.CrossRefPubMedGoogle Scholar
  20. 20.
    Helis CA, Lucas JT, Bourland JD, Chan MD, Tatter SB, Laxton AW. Repeat radiosurgery for trigeminal neuralgia. Neurosurgery. 2015;77:755–61.CrossRefPubMedGoogle Scholar
  21. 21.
    Zorro O, Lobato-Polo J, Kano H, Flickinger J, Lunsford L, Kondziolka D. Gamma Knife radiosurgery for multiple sclerosis-related trigeminal neuralgia. Neurology. 2009;73:1149–54.CrossRefPubMedGoogle Scholar
  22. 22.
    Tuleasca C, Carron R, Resseguier N, Donnet A, Roussel P, Gaudart J, Levivier M, Regis J. Multiple-sclerosis related trigeminal neuralgia: a prospective series of 43 patients treated with Gamma Knife surgery with more than one year of follow-up. Streotact Funct Neurosurg. 2014;92:203–10.CrossRefGoogle Scholar
  23. 23.
    Eller JL, Raslan AM, Burchiel KJ. Trigeminal neuralgia: definition and classification. Neurosurg Focus. 2005;18:E3.CrossRefPubMedGoogle Scholar
  24. 24.
    Regis J, et al. Prospective controlled trial of gamma knife surgery for essential trigeminal neuralgia. J Neurosurg. 2006;104:913–24.CrossRefPubMedGoogle Scholar
  25. 25.
    Dhople A, Kwok Y, Chin I, Shepard D, Slawson R, Amin P, Regine W. Efficacy and quality of life outcomes in patients with atypical trigeminal neuralgia treated with Gamma Knife radiosurgery. Int Radiat Oncology Biol Phys. 2007;69(2):397–403.CrossRefGoogle Scholar
  26. 26.
    Brisman R. Microvascular decompression vs. Gamma Knife for typical trigeminal neuralgia: preliminary findings. Stereotact Funct Neurosurg. 2007;85:94–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Linskey ME, Ratanatharathorn V, Penagarciano J. A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia. J Neurosurg. 2008;109(Suppl):160–72.PubMedGoogle Scholar
  28. 28.
    Pollock BE, Schoeberl KA. Prospective comparison of posterior fossa exploration and stereotactic radiosurgery dorsal root entry zone target as a primary surgery for patients with idiopathic trigeminal neuralgia. Neurosurgery. 2010;67:633–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Barker FGII, Jannetta PJ, Bissonette DJ, et al. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334:1077–83.CrossRefPubMedGoogle Scholar
  30. 30.
    Patil CG, Veeravagu A, Bower RS, Li G, Chang SD, Lim M, Adler JR Jr. CyberKnife radiosurgical rhizotomy for the treatment of atypical trigeminal nerve pain. Neurosurg Focus. 2007;23(6):E9.CrossRefPubMedGoogle Scholar
  31. 31.
    Fariselli L, Marras C, De Santis M, Marchetti M, Milanesi I, Broggi G. CyberKnife radiosurgery as a first treatment for idiopathic trigeminal neuralgia. Neurosurgery. 2009;64(Suppl):A96–101.CrossRefPubMedGoogle Scholar
  32. 32.
    Chen JC, Rahimian J, Rahimian R, Arellano A, Miller MJ, Girvigian MR. Frameless image-guided radiosurgery for initial treatment of typical trigeminal neuralgia. World Neurosurg. 2010;74(4–5):538–43.CrossRefPubMedGoogle Scholar
  33. 33.
    Conti A, Pontoriero A, Latì G, Esposito F, Siniscalchi EN, Crimi S, Vinci S, Brogna A, De Ponte F, Germanò A, Pergolizzi S, Tomasello F. Frameless stereotactic radiosurgery for treatment of multiple sclerosis-related trigeminal neuralgia. World Neurosurg. 2017;103:702–12.CrossRefPubMedGoogle Scholar
  34. 34.
    Shields LBE, Shanks TS, Shearer AJ, Shelton LA, Shelton BJ, Howe J, Coons JM, Plato B, Spalding AC. Frameless image-guided radiosurgery for trigeminal neuralgia. Surg Neurol Int. 2017;26:87.Google Scholar
  35. 35.
    Kerolus MG, Sen N, Mayekar S, Templeton A, Turian J, Diaz A, Munoz L, Byrne RW, Sani S. Truebeam radiosurgery for the treatment of trigeminal neuralgia: preliminary results at a single institution. Cureus. 2017;9(6):e1362.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Verbakel WF, Lagerwaard FJ, Verduin AJ, Heukelom S, Slotman BJ, Cuijpers JP. The accuracy of frameless stereotactic intracranial radiosurgery. Radiother Oncol. 2010;97(3):390–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyUniversity of Arkansas for Medical SciencesLittle RockUSA

Personalised recommendations