Using Stereotactic Radiosurgery to Treat Trigeminal Neuralgia
Trigeminal neuralgia is a chronic pain condition characterized by one-sided facial pain, affecting the trigeminal nerve. This nerve is located on the side of the face, stretching from the temple to the lower jaw, and carries sensation from your face to your brain.
Causes of Trigeminal Neuralgia
Trigeminal neuralgia occurs when something interferes with the nerve. The most common causes are:
- Contact between a normal blood vessel and the trigeminal nerve at the base of the brain.
- Aging or multiple sclerosis damaged the sheath that protects the nerves.
- Brain lesions or other abnormalities.
- Surgical injuries, stroke, or facial trauma.
Symptoms include instances of shooting pain that can feel like an electric shock, spontaneous pain attacks caused by touching the face, chewing, or brushing your teeth, and a constant aching or burning feeling.
If diagnosed with trigeminal neuralgia, many different treatment options are available that can help to reduce or block the pain signal to the brain. Taking medications is usually the first course of action to treat the pain. These can include anticonvulsants, antispasmodic agents, or Botox injections. If medications are unable to reduce pain, surgery will be considered. Most of the surgical options for trigeminal neuralgia treatment include incisions and anesthesia, which can result in higher risks to the patient.
Stereotactic radiosurgery (SRS) is the least invasive type of treatment for those diagnosed with this trigeminal neuralgia. SRS is considered a safer option for patients with co-morbidities, high-risk medical illness, or pain refractory from previous surgical procedures. Not surgery in the traditional sense of the word as it does not involve an incision, rather SRS uses a precise beam of photon radiation to accurately treat even the smallest targets. At Ackerman Cancer Center, trigeminal neuralgia can be treated with Gamma Knife or our new cutting-edge SRS technology, the Versa HD.
Stereotactic radiosurgery is used to treat tumors, vascular malformations, and other abnormalities in the brain. When treating trigeminal neuralgia, it delivers a high-dose, one-fraction treatment completed in one day. The root of the trigeminal nerve is targeted, creating a lesion that can reduce or eliminate pain.
For treating trigeminal neuralgia, an MRI or CT scan is done prior to SRS in order to create an image of the nerve fibers to select a target area to treat.
In a recent study, stereotactic radiosurgery including Gamma Knife was the method of treatment for patients diagnosed with trigeminal neuralgia. The study parameters included the degree of pain relief, latency interval to pain relief, the onset of paresthesia, the need for further surgical treatment, and complications. The results showed that:
- 60% of the patients became pain-free and required no further medical treatment
- 17% had a 50%-90% reduction in the severity of pain
- 9% had only a slight improvement in pain
Overall, roughly 80% of patients saw a significant change in pain relief and a low pain recurrence rate.
Visit Ackerman Cancer Center treatment options for more information on the advanced treatment options we offer, including Gamma Knife Radiosurgery and our new Versa HD.