Repeat gamma knife stereotactic radiosurgery in the treatment of trigeminal neuralgia: A single-center experience and focused review of the literature

Omar, Nidal B.; Amburgy, John; Self, D. Mitchell; Christen, Andrée; Larios, E.A.; Ditty, Benjamin J.; Jacob, Robin; Fiveash, John B.; Spencer, Sharon A.; Markert, James M.; Guthrie, Barton L.; Fisher, Winfield S.; Chambers, M. R.

doi:10.1016/j.jocn.2019.08.061

Cited by 9 publications

(8 citation statements)

References 18 publications

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“…However, more clinical data are still needed to validate this idea. Stereotactic radiosurgery is the least invasive procedure and a commonly accepted treatment for refractory TN ( 33 ). However, the short duration of pain relief is one of the reasons why it has not been chosen by many neurosurgeries.…”

Section: Discussionmentioning

confidence: 99%

Global Trends and Hotspots in Trigeminal Neuralgia Research From 2001 to 2021: A Bibliometric Analysis

Zhu

Xiang

et al. 2022

Front. Neurol.

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BackgroundIn recent years, there have been an increasing number of studies on trigeminal neuralgia (TN). However, a scientific and comprehensive study of the current situation and trends in the field of TN research is lacking. The purpose of this study is to summarize and visualize the development, research hotspots, and future trends in TN based on a bibliometric approach.MethodsStudies on TN published from 2001 to 2021 were obtained from the Web of Science Core Collection (WoSCC). Bibliometrics, CiteSpace, and VOSviewer tools were used for bibliometric analysis and visualization.ResultsIn total, 4,112 documents were searched. The number of research articles in the field is generally on an upward trend, with the fastest growth in the number of articles from 2017 to 2020. Shanghai Jiao Tong University, Pittsburgh University, and Mayo Clinic are the three institutions with the most publications. Shiting Li and Zakrzewska JM are the most prolific author and top co-cited authors, respectively. The Journal of Neurosurgery is the most influential journal. The top 5 keywords in that time frame are TN, microvascular decompression, facial pain, stereotactic radiosurgery, and neuropathic pain.ConclusionThis is the first comprehensive scientific bibliometric analysis of the global research field on TN over the past 21 years, providing a meaningful reference for further exploration of topical issues and research trends in the field.

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Section: Discussionmentioning

confidence: 99%

Global Trends and Hotspots in Trigeminal Neuralgia Research From 2001 to 2021: A Bibliometric Analysis

Zhu

Xiang

et al. 2022

Front. Neurol.

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“…Onset of pain relief is delayed, ranging from 15 to 78 days on average, up to 6 months. As is the case with percutaneous treatments, retreatment is possible, but, though effective, there is a greater risk of complications [ 69 ]. The benefit of repeated GKRS has been greater in those subjects who also had facial sensory loss.…”

Section: Discussionmentioning

confidence: 99%

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Gerwin

2020

IJERPH

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Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15–20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.

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“…In general, a higher dose is associated with more prompt pain reduction and a higher rate of overall response [ 29 , 31 , 32 , 39 , 52 - 54 ]. At the same time, a higher dose, particularly applied to the brainstem, is associated with a higher rate of trigeminal neuropathy [ 4 , 8 , 10 , 15 , 19 , 20 , 22 , 23 , 30 , 45 , 48 , 49 , 56 ]. Not only the absolute dose but also dose rate was suggested as a factor that might influence the outcome.…”

Section: Past Controversies About Gkrs For Tn and Current Consensusmentioning

confidence: 99%

“…Although only minimal facial numbness was reported by patients, the occurrence of trigeminal nerve dysfunction was increased following repeat GKRS in a median of 42% (range, 11–74%) of the patients. The maximum target dose was reduced at the second radiation in most institutions by a median of 10 Gy (range, 0.9–35) [ 4 , 8 , 10 , 15 , 19 , 20 , 22 , 23 , 30 , 45 , 48 , 49 , 56 ]. The trigeminal target at the second GKRS was usually placed more distally or proximally to minimize overlap.…”

Section: Repeat Gkrs For Tnmentioning

confidence: 99%

Gamma Knife Radiosurgery for Trigeminal Neuralgia : Review and Update

Lee

2022

J Korean Neurosurg Soc

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Accurate diagnosis of trigeminal neuralgia (TN) is the starting point for optimal treatment. Gamma knife radiosurgery (GKRS) is currently regarded as one of the first-line treatment options for medically refractory TN. GKRS is a less invasive treatment with a low risk of complications than other surgical procedures that provides a favorable pain control (BNI I-IIIb) rate of > 75 % at short-term follow-up. Drawbacks of GKRS include the latency period before pain relief and higher recurrence rate compared with microvascular decompression. Therefore, repeat treatment is necessary if the initial GKRS was effective but followed by recurrence. The concept of dose rate and the biologically effective dose of radiation has been actively studied in radiation oncology and is also applied in GKRS for TN to achieve high safety and efficacy by prescribing the optimal dose. Recent progress in functional imaging, such as diffusion tensor imaging, enables us to understand the pathophysiology of TN and predict the clinical outcome after GKRS. Here, we review TN, GKRS, and recent updates, especially in the concepts of radiation dose, diffusion tensor imaging studies, and repeat treatment in GKRS for TN.

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Repeat gamma knife stereotactic radiosurgery in the treatment of trigeminal neuralgia: A single-center experience and focused review of the literature

Cited by 9 publications

References 18 publications

Global Trends and Hotspots in Trigeminal Neuralgia Research From 2001 to 2021: A Bibliometric Analysis

Global Trends and Hotspots in Trigeminal Neuralgia Research From 2001 to 2021: A Bibliometric Analysis

Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome—An Evidence-Based Narrative Review and Etiological Hypothesis

Gamma Knife Radiosurgery for Trigeminal Neuralgia : Review and Update

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