Review Article

Clinical Outcomes of Gamma Knife Radiosurgery in the Treatment of Patients with Trigeminal Neuralgia

Table 3

Clinical outcomes of patients undergoing single versus multiple Gamma Knife treatments.

Author (year)Clinical evaluation methodGKRS max dose (Gy)Study endpointsResults

BNI scores of I–IIIb at 1-y for idiopathic TN75%
BNI scores of I–IIIb at 3-y for idiopathic TN60%
BNI scores of I–IIIb at 5-y for idiopathic TN58%
Verheul et al. [33] (2010)BNI1st treatment: 80
2nd treatment: 80
BNI scores of I–IIIb at 1-y for MS-related TN56%
BNI scores of I–IIIb at 3-y for MS-related TN30%
BNI scores of I–IIIb at 5-y for MS-related TN20%
5-y idiopathic retreatment pain relief rate75%
5-y MS retreatment pain relief rate46%

Pain outcome in primary versus secondary GKRSP = NS
Park et al. [34] (2011)BNI1st treatment mean: 82.4 ± 6.25
2nd treatment mean: 81 ± 4.89
Primary GKRS facial numbness21%
Secondary GKRS facial numbness45.8%

BNI score of I–III at 1-y75%
Patients requiring additional surgery41%
Little et al. [35] (2009)BNI1st treatment: 80
2nd treatment: 40–50
Patients with mild facial numbness76%
Patients with bothersome facial numbness8%
Patients with eye symptoms12%

BNI scores of I–IIIb at 1-y82.6%
Zorro et al. [3] (2009)BNIMedian: 80BNI scores of I–IIIb at 3-y73.9%
BNI scores of I–IIIb at 5-y54%
Patients with facial sensory dysfunction5.4%

1-y no previous treatment excellent outcome rate82.5%
1-y previous treatment excellent outcome rate69.4%
Fountas et al. [36] (2007)EGFPMedian: 802-y no previous treatment excellent outcome rate78%
2-y previous treatment excellent outcome rate63.5%
No previous treatment paresthesia rate15.8%
Previous treatment paresthesia rate16.3%

1-y no previous treatment excellent outcome rate80.8%
1-y previous treatment excellent outcome rate69.2%
Fountas et al. [37] (2006)EGFPMedian: 802-y no previous treatment excellent outcome rate64%
2-y previous treatment excellent outcome rate11.5%
No previous treatment facial numbness rate17.3%
Previous treatment facial numbness rate16%

1st treatment excellent outcome rate56%
1st treatment good outcome rate13.5%
Huang et al. [38] (2008)EGFP1st treatment mean: 79
2nd treatment mean: 52
1st treatment fair outcome rate7.9%
2nd treatment excellent outcome rate55%
2nd treatment good outcome rate5%
Facial numbness associated with repeat GKRSP = 0.007

Huang et al. [39] (2008)EGFPMean: 60.7Excellent outcome rate after GKRS to the tumor57%
Excellent outcome rate after GKRS to CN V50%

BNI: Barrow Neurological Institute; CN: cranial nerve; EGFP: excellent-good-fair-poor; GKRS: Gamma Knife radiosurgery; NS: nonsignificant.