Gamma knife radiosurgery: Making lives merrier for refractory trigeminal neuralgia

Abstract

Trigeminal neuralgia (TN), also known as tic Dolorex, is a unilateral paroxysmal lancinating pain affecting one or more of the branches of the trigeminal nerve. The treatment of TN can be very challenging despite the numerous options patients and physicians can choose from. Stereotactic radiosurgery (SR) with gamma knife surgery (GKS) is a rapidly emerging surgical modality in the management of medically refractory TN. GKS is the most recent and least invasive neurosurgical treatment alternative to microvascular decompression and rhizotomies. The gamma knife is a complex machine that uses cobalt-60 as energy and is able to focus a precise intersection of 201 beams of these gamma rays to perform radiosurgery. It is associated with a low risk of facial paresthesia, an approximately 80% rate of significant pain relief, and a low recurrence rate.