Gamma Knife stereotactic radiosurgery
for trigeminal neuralgia
Overview
Medical management with medication is the first line of treatment for trigeminal neuralgia. Patients whose pain is not controlled with medicines may benefit from surgical interventions including Gamma Knife stereotactic radiosurgery.
The primary goal of Gamma Knife radiosurgery is to provide optimal pain control whilst avoiding loss of sensation on the face (hypesthesia) or keeping it to an absolute minimum.
Patients and their treatment team need to weigh up achieving pain control using Gamma Knife treatment against some loss of sensation on the face that can occur.

How Gamma Knife radiosurgery works
With Gamma Knife surgery, a multidisciplinary team, uses computer imagery to direct a precisely focused beam of high-dose radiation to the trigeminal nerve. This causes a lesion (something like a scar) to form on the nerve, which eventually disrupts the transmission of pain signals to the brain.
Pain relief after Gamma Knife surgery occurs gradually. If pain is not controlled, the procedure can be repeated.
- Open microvascular decompression
- Previous surgical treatment on the same side or atypical trigeminal neuralgia.
Research1 indicates that as many as 96 % of trigeminal neuralgia patients experience pain relief within a few weeks after their Gamma Knife procedure. Just2 over 90 % of patients will not need another surgery within the first year. This does drop to 67.7 % at 10 years and remains at this level until 14 years.
The majority of the patients say that their quality of life improved after Gamma Knife radiosurgery and that the hypesthesia or loss of sensation on the face, when present, was a good trade-off for pain relief.
One in two patients will still need some medication to manage any pain but the doses are much lower and manageable.
Research has shown that following Gamma Knife radiosurgery:
- 93.8 % of patients were pain free with or without medication
- No patients developed an early complication.
The Marseille Technique – Gamma Knife outcomes improved
- 92 % had complete or significant relief from pain at one year
- 80 % had relief at 5 years and
- 68 % had relief at 10 years.
Gamma Knife radiosurgery versus traditional surgery
The advantage of Gamma Knife radiosurgery over the traditional surgical approach is that, if patients develop hypesthesia or loss of sensation on the face, it is only partial.
With the surgical approach patients can have total hypesthesia or loss of sensation on the face.