A successful case of multiple stereotactic radiosurgeries for ipsilateral recurrent trigeminal neuralgia

Abstract

Trigeminal neuralgia is a common pain syndrome primarily managed medically, although many patients require surgical or radiotherapeutic intervention. Stereotactic radiosurgery has become a preferred method of treatment given its high efficacy rates and relatively favorable toxicity profile. However, many patients have refractory pain even after repeat courses of stereotactic radiosurgery. Historically, 2 courses have been the limit in such patients. The authors present a case of multiply recurrent trigeminal neuralgia treated with a third course of radiosurgery in which the patient had successful pain control and no additional toxicity. Meticulous attention to the therapeutic technique allows the continued application of stereotactic radiosurgery in patients.

Keywords: BNI = Barrow Neurological Institute; GKRS = Gamma Knife radiosurgery; Gamma Knife; MVD = microvascular decompression; TN = trigeminal neuralgia; functional neurosurgery; pain; radiosurgery; repeat Gamma Knife; repeat stereotactic radiosurgery; trigeminal neuralgia.