Professional overview
for trigeminal neuralgia
Key takeouts
Probability of freedom from pain after Gamma Knife stereotactic radiosurgery (GKSR)
Sensory dysfunction
No patients developed an early complication after GKSR. However, during the first 5 years after radiosurgery, 19.8 % of patients developed new sensory dysfunction (paresthesias or facial sensory loss), with most experiencing this at 12 months. After peaking at 20.8 % at 7 years, the rate remained stable until 14 years. Sensory dysfunction was mild in 18.8 % of patients, somewhat bothersome in 0.8 %, and very bothersome in 0.8 %.
Quality of life
Probability of pain relief without medication
Some patients will need to take lower doses of medication to control their pain.
After 1 year, 85.9 % were pain free without medication dropping to 45.3 % at 10 years. The probability of achieving and maintaining pain relief without medication at 0.5, 1, 2, 3, 5, 7, 10, 12 and 14 years was 93.4, 85.9, 78.6, 71.8, 64.9, 59.7, 45.3, 40.7 and 33.9 %, respectively.
The probability of remaining pain free was higher, with a shorter delay between trigeminal neuralgia pain onset and radiosurgery [p = 0.04, hazard ratio (HR) = 1, 95 % confidence interval (CI) = 0.99–1] but was not influenced by the development of post radiosurgery hypoesthesia (p = 0.88) or the existence of a neurovascular conflict on MRI (p = 0.38), with the same applying to plugging (p = 0.14). Furthermore, an earlier initial response predicted a better long-term benefit (p < 0.05).