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Clinical Study

Single-Institution Retrospective Series of Gamma Knife Radiosurgery in the Treatment of Multiple Sclerosis-Related Trigeminal Neuralgia: Factors that Predict Efficacy

Weller M.a · Marshall K.c · Lovato J.F.d · Bourland J.D.c · deGuzman A.F.c · Munley M.T.c · Shaw E.G.c · Tatter S.B.b · Chan M.D.c

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aDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, and Departments of bNeurosurgery, cRadiation Oncology and dPublic Health Sciences, Wake Forest University Health Sciences, Winston-Salem, N.C., USA

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Stereotact Funct Neurosurg 2014;92:53-58

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: January 07, 2013
Accepted: August 06, 2013
Published online: November 08, 2013
Issue release date: January 2014

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

Background: Gamma knife radiosurgery (GKRS) has been reported as a treatment option for multiple sclerosis (MS)-related trigeminal neuralgia. Objective: To report the outcomes of a single-institution retrospective series of MS-related trigeminal neuralgia. Methods: Between 2002 and 2010, 35 patients with MS-related trigeminal neuralgia were treated with GKRS. The median maximum dose was 90 Gy. Data were analyzed to determine the response to GKRS and factors that may predict for efficacy. Results: Of the 35 patients, 88% experienced a Barrow Neurological Institute (BNI) pain score of I-III at 3 months after GKRS. Kaplan-Meier estimates of 1-, 2- and 5-year freedom from BNI IV-V pain relapse were 57, 57 and 52%, respectively. Numbness was experienced by 39% of patients after GKRS, though no patients reported bothersome numbness. Several differences were noted between how the MS-related variant responded to GKRS and what has previously been reported for idiopathic trigeminal neuralgia. These include the observations that development of post-GKRS numbness did not predict for treatment response (p = 0.62) and that dorsal root entry zone dose did not predict for freedom from pain relapse (odds ratio 1.01, p = 0.1). Active smoking predicted for freedom from pain relapse (odds ratio 67.4, p = 0.04). Conclusion: GKRS is a viable noninvasive treatment option for MS-related trigeminal neuralgia.

© 2013 S. Karger AG, Basel


References

  1. Kanpolat Y, Berk C, Savas A, Bekar A: Percutaneous controlled radiofrequency rhizotomy in the management of patients with trigeminal neuralgia due to multiple sclerosis. Acta Neurochir (Wien) 2000;142:685-689, discussion 689-690.
  2. Kondziolka D, Lunsford LD, Bissonette DJ: Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia. Can J Neurol Sci 1994;21:137-140.
    External Resources
  3. Resnick DK, Jannetta PJ, Lunsford LD, Bissonette DJ: Microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis. Surg Neurol 1996;46:358-361, discussion 361-362.
  4. Sandell T, Eide PK: The effect of microvascular decompression in patients with multiple sclerosis and trigeminal neuralgia. Neurosurgery 2010;67:749-753, discussion 753-754.
  5. Diwanji TP, Dhople AA, Chin LS, Maggio WW, Adams JR, Regine WF, Kwok Y: Long-term outcome of gamma knife radiosurgery for multiple sclerosis related trigeminal neuralgia. Int J Radiat Oncol Biol Phys 2010;78:S264-S265.
  6. Huang E, Teh BS, Zeck O, Woo SY, Lu HH, Chiu JK, Butler EB, Gormley WB, Carpenter LS: Gamma knife radiosurgery for treatment of trigeminal neuralgia in multiple sclerosis patients. Stereotact Funct Neurosurg 2002;79:44-50.
  7. Rogers CL, Shetter AG, Ponce FA, Fiedler JA, Smith KA, Speiser BL: Gamma knife radiosurgery for trigeminal neuralgia associated with multiple sclerosis. J Neurosurg 2002;97:529-532.
    External Resources
  8. Zorro O, Lobato-Polo J, Kano H, Flickinger JC, Lunsford LD, Kondziolka D: Gamma knife radiosurgery for multiple sclerosis-related trigeminal neuralgia. Neurology 2009;73:1149-1154.
  9. Marshall K, Chan MD, McCoy TP, Aubuchon AC, Bourland JD, McMullen KP, deGuzman AF, Munley MT, Shaw EG, Tatter SB, Ellis TL: Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery. Neurosurgery 2012;70:566-572, discussion 572-573.
  10. Kondziolka D, Zorro O, Lobato-Polo J, Kano H, Flannery TJ, Flickinger JC, Lunsford LD: Gamma knife stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 2010;112:758-765.
  11. Aubuchon AC, Chan MD, Lovato JF, Balamucki CJ, Ellis TL, Tatter SB, McMullen KP, Munley MT, Deguzman AF, Ekstrand KE, Bourland JD, Shaw EG: Repeat gamma knife radiosurgery for trigeminal neuralgia. Int J Radiat Oncol Biol Phys 2011;81:1059-1065.
  12. Regis J, Manera L, Dufour H, Porcheron D, Sedan R, Peragut JC: Effect of the gamma knife on trigeminal neuralgia. Stereotact Funct Neurosurg 1995;64(suppl 1):182-192.
  13. Burchiel KJ, Slavin KV: On the natural history of trigeminal neuralgia. Neurosurgery 2000;46:152-154, discussion 154-155.
  14. Eller JL, Raslan AM, Burchiel KJ: Trigeminal neuralgia: definition and classification. Neurosurg Focus 2005;18:E3.
  15. Broggi G, Ferroli P, Franzini A, Servello D, Dones I: Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2000;68:59-64.
  16. Nurmikko TJ: Pathophysiology of MS-related trigeminal neuralgia. Pain 2009;143:165-166.
  17. Pickett GE, Bisnaire D, Ferguson GG: Percutaneous retrogasserian glycerol rhizotomy in the treatment of tic douloureux associated with multiple sclerosis. Neurosurgery 2005;56:537-545, discussion 537-545.
  18. Montano N, Papacci F, Cioni B, Di Bonaventura R, Meglio M: Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis. Analysis of the potentially prognostic factors. Acta Neurochir (Wien) 2012;154:779-783.
  19. Riesenburger RI, Hwang SW, Schirmer CM, Zerris V, Wu JK, Mahn K, Klimo P Jr, Mignano J, Thompson CJ, Yao KC: Outcomes following single-treatment gamma knife surgery for trigeminal neuralgia with a minimum 3-year follow-up. J Neurosurg 2010;112:766-771.
  20. Brisman R, Mooij R: Gamma knife radiosurgery for trigeminal neuralgia: dose-volume histograms of the brainstem and trigeminal nerve. J Neurosurg 2000;93(suppl 3):155-158.
    External Resources
  21. Marrie RA, Horwitz RI: Emerging effects of comorbidities on multiple sclerosis. Lancet Neurol 2010;9:820-828.
  22. Pollock BE, Phuong LK, Gorman DA, Foote RL, Stafford SL: Stereotactic radiosurgery for idiopathic trigeminal neuralgia. J Neurosurg 2002;97:347-353.
    External Resources
  23. Lowell D, Tatter SB, Bourland JD, DeGuzman AF, Ekstrand KE, Ellis TL, Lovato J, McMullen KP, Munley MT, Shaw EG, Urbanic JJ, Chan MD: Toxicity of gamma knife radiosurgery in the treatment of intracranial tumors in patients with collagen vascular diseases or multiple sclerosis. Int J Radiat Oncol Biol Phys 2011;81:e519-e524.
  24. Kondziolka D, Lacomis D, Niranjan A, Mori Y, Maesawa S, Fellows W, Lunsford LD: Histological effects of trigeminal nerve radiosurgery in a primate model: implications for trigeminal neuralgia radiosurgery. Neurosurgery 2000;46:971-976, discussion 976-977.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: January 07, 2013
Accepted: August 06, 2013
Published online: November 08, 2013
Issue release date: January 2014

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN


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