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AANS: Radiosurgery Effective for Trigeminal Neuralgia

Eight in 10 patients report good to excellent pain reduction following stereotactic radiosurgery

THURSDAY, April 19 (HealthDay News) -- Linear accelerator-based stereotactic radiosurgery is a safe and effective, long-term treatment for trigeminal neuralgia, according to a report presented this week at the annual meeting of the American Association of Neurological Surgeons in Washington, D.C.

Zachary Smith, M.D., of the University of California, Los Angeles, and colleagues followed 169 patients with idiopathic, secondary, or atypical trigeminal neuralgia that were treated with radiosurgery at UCLA over a 10-year period. During that time, the treatment protocol evolved with respect to dosage (70 to 90 Gray), isocenter size (5 to 7.5 mm), and isodose-line irradiation of the brainstem (30 percent to 50 percent).

Eighty-two percent of patients with essential trigeminal neuralgia reported good to excellent pain reduction following radiosurgery. Eighty-two percent of patients who had undergone prior surgical procedures reported good to excellent results, compared to 87 percent among patients for whom radiosurgery was the first treatment. While postoperative trigeminal nerve dysfunction occurred in between 20 percent and 23 percent of patients at both 70 and 90 Gray doses, treatment efficacy improved with higher doses, while recurrence rates and time to pain relief decreased.

"Radiosurgery for trigeminal neuralgia is safe and effective," the authors wrote. "The isocenter dose at the brainstem may have important implications for pain control and numbness."

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