Results of GK re-treatment of trigeminal neuralgiaKeywords: pain, outcome, trigeminal neuralgia, gamma knife, recurrent diseaseInteractive Manuscript
Ask Questions of this Manuscript:
What is the background behind your study?
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.
What is the purpose of your study?
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.
Describe your patient group.
26 patients were identified ( 19 female , 7 male ).
Describe what you did.
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.
Describe your main findings.
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
Describe the main limitation of this study.
This was a retrospective study.
Describe your main conclusion.
Retreatment using GK for TGN is an effective pain management tool.
Describe the importance of your findings and how they can be used by others.
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.
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.
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