Gamma knife radiosurgery in patients with trigeminal neuralgia: Quality of life, outcomes, and complications

Objective: to assess the outcomes, complications, and alteration in quality of life (QOL) in patients with trigeminal neuralgia who were treated with gamma knife radiosurgery (GKRS) in a prospective observational study. Methods and materials: between June 2006 and May 2007, 30 patients of medically refractory trigeminal neuralgia were included in our study and treated with GKRS at Iran Gamma Knife Centre (IGKC), Tehran, Iran. A median maximum prescription dose of 90 Gy (range: 85-95) was delivered to the trigeminal nerve root entry zone. All involved patients completed QOL questionnaire SF-36 before GKRS and 9-12 months after it. All data from questionnaires and the basic characteristics of the radiosurgery and patients were analyzed using descriptive statistics, paired T-test, Fisher's exact test, bivariate correlation, and independent sample T-test. Results: In all SF-36 domains significant changes before and after GKRS were noticed except physical function (PF) and role limitation due to physical problem (RP). Bodily pain after GKRS was 100 (excellent result) in 12 (40%) of study participants, 90-99 (good result) in 3 (10%), 50-89 (fair result) in 10 (33%) and less than 50 (poor result) in five (17%). Four cases (13%) faced to facial numbness. No other complications were noticed. Conclusions: GKRS positively changes the several aspect of QOL especially those related to pain relief and mental health component of QOL The rate of diminishing pain in our study is comparable with other series. The GKRS complication is limited in both variety and number. (c) 2008 Elsevier B.V. All rights reserved.