Abstract
Stereotactic radiosurgery has a number of applications in craniofacial pain syndromes, movement disorders, and psychiatric disorders. For patients with medically refractory trigeminal neuralgia deemed ineligible for microvascular decompression, stereotactic radiosurgery is an attractive therapeutic option. Significant improvement can be seen in approximately 85% of patients, with trigeminal sensory changes occurring in only 10%–20% of treated patients. Stereotactic radiosurgery may also be effective in a number of other craniofacial pain conditions, including multiple sclerosis–related trigeminal neuralgia, tumor-related trigeminal neuralgia, glossopharyngeal neuralgia, and sphenopalatine neuralgia. Based on the current evidence, radiosurgery demonstrates efficacy and complication rates similar to deep brain stimulation and focused ultrasound for the treatment of medically refractory tremor. Radiosurgery also has been utilized in a limited fashion as a lesioning modality for a number of medically refractory and severe psychiatric disorders, including obsessive compulsive disorder.
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