Results of GK re-treatment of trigeminal neuralgia

James Fontanesi1, Ann Maitz2, Kim Marvin2

1Bloomfield Hills, United States 2William Beaumont Hospital

Keywords: recurrent disease, gamma knife, trigeminal neuralgia, outcome, pain

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Abstract

     Trigeminal Neuralgia ( TGN ) is a well recognized clinical entity which has a high response rate to intervention with stereotactic radiation techniques. However for a finite group of patients treatment is either unsucessful of the pain returns after a period of initial response.
     We have retospectively reviewed the experience at William Beaumont Hospital in the re-treatment of TGN and report on its results in terms of pain relief and complication.
     26 patients were identified ( 19 female , 7 male ).
     After IRB approval , a retospective review of all patients who received re treatment for TGN was undertaken. Various data points including pains scores are obtained prospectively on all patients and are also collected in follow up. These data points are the basis of this report.
      Median follow up following second treatment was 11 months. Pre treatment BNI scores were either 4 ( n=21 ) or 5 ( n=5). Re-treatment was as follows 30-35 Gy at 50% IDL (n=23 ) or 40 Gy at 50% IDL ( n=3 ) Shot utilization included 1 shot in 22 cases and 2 shots in 4 At last follow up BNI scores were 1 (n=11), 2-3 ( n=10 ), 4-5 (n=4). 13 ( 50% ) demonstrated BNI improvement of at least 2 levels while only 3 had stable BNI scores ( 7.6 % ). Overall 92% had a positve response
     This was a retrospective study.
     Retreatment using GK for TGN is an effective pain management tool.
     We could not define any single factor from our database that would suggest who best benefits from treatment. We will continue to offer retreatment as a viable option for recurrent TGN.


Acknowledgements

Project Roles:

J. Fontanesi (), A. Maitz (), K. Marvin ()