Single-institution retrospective series of gamma knife radiosurgery in the treatment of multiple sclerosis-related trigeminal neuralgia: factors that predict efficacy.
Stereotact Funct Neurosurg
; 92(1): 53-8, 2014.
Article
em En
| MEDLINE
| ID: mdl-24217153
ABSTRACT
BACKGROUND:
Gamma knife radiosurgery (GKRS) has been reported as a treatment option for multiple sclerosis (MS)-related trigeminal neuralgia.OBJECTIVE:
To report the outcomes of a single-institution retrospective series of MS-related trigeminal neuralgia.METHODS:
Between 2002 and 2010, 35 patients with MS-related trigeminal neuralgia were treated with GKRS. The median maximum dose was 90 Gy. Data were analyzed to determine the response to GKRS and factors that may predict for efficacy.RESULTS:
Of the 35 patients, 88% experienced a Barrow Neurological Institute (BNI) pain score of I-III at 3 months after GKRS. Kaplan-Meier estimates of 1-, 2- and 5-year freedom from BNI IV-V pain relapse were 57, 57 and 52%, respectively. Numbness was experienced by 39% of patients after GKRS, though no patients reported bothersome numbness. Several differences were noted between how the MS-related variant responded to GKRS and what has previously been reported for idiopathic trigeminal neuralgia. These include the observations that development of post-GKRS numbness did not predict for treatment response (p = 0.62) and that dorsal root entry zone dose did not predict for freedom from pain relapse (odds ratio 1.01, p = 0.1). Active smoking predicted for freedom from pain relapse (odds ratio 67.4, p = 0.04).CONCLUSION:
GKRS is a viable noninvasive treatment option for MS-related trigeminal neuralgia.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neuralgia do Trigêmeo
/
Radiocirurgia
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Esclerose Múltipla
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Stereotact Funct Neurosurg
Assunto da revista:
NEUROCIRURGIA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Estados Unidos