BACKGROUND:
Tic douloureux is a debilitating disease presented as a recurrent unilateral short- living, electric, shock -like pain, abrupt in onset and termination, limited to the distribution of one or more division of trigeminal nerve.
OBJECTIVE:
To evaluate the effectiveness of Gamma Knife® radiosurgery (GKRS) using retrogasserian approach.
PATIENTS AND METHODS:
A follow up review was conducted on twenty patients who were treated with GKRS for refractory TN at our institution Dr. Saad Al-Witry Neuroscience Hospital in Baghdad, Iraq, between December 2019 and March 2021. T.N pain score was assessed using the Barrow Neurological Institute (BNI) Pain Scale. An ideal result was counted by post-GKRS BNI score of (I–III), whereas insufficiency outcome was (IV – V) of same scale.
RESULTS:
From the entire (twenty) GKRS procedures, (85%) of patients had result with remarkable relief in their complain (BNI I-III). No noteworthy relation was found between unacceptable outcome and age, sex, side of complain, period of symptoms. Only four cases (20%) developed undesirable outcome in form of facial numbness.
CONCLUSION:
Considering the satisfactory results in our own experience, GKRS is also offered as a feasible, effective, safe initial and repeat treatment modality targeting patients who were intractable to medical treatment.
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- Dhople AA, Adams JR, Maggio WW, Naqvi SA, Regine WF, Kwok Y. Long-term outcomes of Gamma Knife radiosurgery for classic trigeminal neuralgia: implications of treatment and critical review of the literature. Journal of neurosurgery. 2009;111:351-58.
- Santo Neto H, Camilli JA, Marques MJ. Trigeminal neuralgia is caused by maxillary and mandibular nerve entrapment: greater incidence of right-sided facial symptoms is due to the foramen rotundum and foramen ovale being narrower on the right side of the cranium. Medical hypotheses. 2005 ;65:1179-82.
- Vasappa CK, Kapur S, Krovvidi H. Trigeminal neuralgia. BJA Educ. 2016;16:353–56.
- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia Int J Headache. 2018;38:1–211.
- Tavakol S, Jackanich A, Strickland BA, Marietta M, Ravina K, Yu C, Chang EL, Giannotta S, Zada G. Effectiveness of gamma knife radiosurgery in the treatment of refractory trigeminal neuralgia: a case series. Operative Neurosurgery. 2020;18:571-6.
- Karam SD, Tai A, Wooster M, Rashid A, Chen R, Baig N, Jay A, Harter KW, Randolph-Jackson P, Omogbehin A, Aulisi EF. Trigeminal neuralgia treatment outcomes following Gamma Knife radiosurgery with a minimum 3-year follow-up. Journal of radiation oncology. 2014;3:125-30.
- Dellaretti M, Reyns N, Touzet G, Sarrazin T, Dubois F, Lartigau E, et al. Clinical outcomes after Gamma Knife surgery for idiopathic trigeminal neuralgia: review of 76 consecutive cases. J Neurosurg. 2008;109 Suppl:173–78.
- Riesenburger RI, Hwang SW, Schirmer CM, Zerris V, Wu JK, Mahn K, Klimo P, Mignano J, Thompson CJ, Yao KC. Outcomes following single-treatment Gamma Knife surgery for trigeminal neuralgia with a minimum 3-year follow-up. Journal of neurosurgery. 2010;112:766-71.
- Little AS, Shetter AG, Shetter ME, Bay C, Rogers CL. Long-term pain response and quality of life in patients with typical trigeminal neuralgia treated with gamma knife stereotactic radiosurgery. Neurosurgery. 2008;63:915-24.
- Little AS, Shetter AG, Shetter ME, Kakarla UK, Rogers CL. Salvage gamma knife stereotactic radiosurgery for surgically refractory trigeminal neuralgia. International Journal of Radiation Oncology* Biology* Physics. 2009;74:522-27.
- Nanda A, Javalkar V, Zhang S, Ahmed O. Long term efficacy and patient satisfaction of microvascular decompression and gamma knife radiosurgery for trigeminal neuralgia. Journal of Clinical Neuroscience. 2015;22:818-22.
- Mueller D, Obermann M, Yoon M-S, Poitz F, Hansen N, Slomke M-A, et al. Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study. Cephalalgia Int J Headache. 2011;31:1542–48.
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