Stereotactic radiosurgery (SRS) offers a reasonable benefit to risk profile for patients with multiple sclerosis (MS)-related trigeminal neuralgia who have exhausted medical management, according to a recent study. Furthermore, more favorable initial response to SRS may predict a long-lasting pain control. Researchers conducted a retrospective cohort study consisting of 263 patients contributed by 9 member tertiary referral gamma knife centers (2 in Canada and 7 in USA) of the International Gamma Knife Research Consortium (IGKRF). They found:
- The median latency period of pain response (PR) after SRS was 1 month.
- Reasonable pain control (Barrow Neurological Institute [BNI] Pain Scores I-IIIb) was achieved in 232 patients (88.2%).
- The median maintenance period from SRS was 14.1 months (range, 10 days to 10 years).
- The actuarial reasonable pain control maintenance rates at 1 year, 2 years, and 4 years were 54%, 35%, and 24%, respectively.
- Among 210 patients with known status of post-SRS complications, the new-onset of facial numbness (BNI-I or II) after SRS occurred in 21 patients (10%).
Xu Z, Mathieu D, Heroux F, et al. Stereotactic radiosurgery for trigeminal neuralgia in patients with multiple sclerosis: A multicenter study. [Published online ahead of print April 23, 2018]. Neurosurgery. doi:10.1093/neuros/nyy142.
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