[Linear accelerator radiosurgery for trigeminal neuralgia]

Varela-Lema L, Maceira-Rozas MC, Ferreiro Cadahía I
Record ID 32013000854
Authors' objectives: To assess the effectiveness and safety of linear-accelerator stereotactic radiosurgery for the treatment of patients with trigeminal neuralgia who are either resistant to drugs despite the use of adequate doses or cannot tolerate medical treatment due to adverse effects.
Authors' recommendations: The results suggest that stereotactic surgery with linear accelerators could constitute an effective and safe therapeutic alternative for treating patients with drug-resistant trigeminal neuralgia. The evidence indicates that success could be similar or even greater than that achieved with the Gamma Knife® but, since there are no randomised clinical trials, it is impossible to establish the true effectiveness and safety of this or other available surgical procedures (percutaneous rhizotomy or microvascular decompression). Based on indirect comparisons, stereotactic radiosurgery is thought to be possibly less effective but safer than percutaneous rhizotomy, with severe sensorial deficits or complications outside the trigeminal distribution being less frequent. Microvascular decompression yields better long-term results but requires a craniotomy or other available surgical alternatives (percutaneous rhizotomy or microvascular decompression). Existing studies leave important doubts as to optimal treatment doses or the therapeutic target, and do not help identify which subgroups of patients could most benefit from this technique. With a view to drawing up indications for use, we thus feel that comparative studies should be undertaken to enable clarification of existing doubts and verification of long-term recurrence.
Project Status: Completed
Year Published: 2013
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Humans
  • Radiosurgery
  • Trigeminal Neuralgia
  • Particle Accelerators
Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)
Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;
Contact Name: avalia-t@sergas.es
Contact Email: avalia-t@sergas.es
Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)
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