Radiosurgery or Gamma knife treatment for Trigeminal neuralgia is a technique developed and made more precise over the last twenty years as an alternative to other forms of ‘surgical treatments’. Strictly speaking Microvascular decompression is the only surgical procedure that has the potential to treat or cure Trigeminal neuralgia.
What is Radiosurgery or Gamma knife treatment for Trigeminal neuralgia?
Radiosurgery or Gamma knife treatment is a type of no-incision or bloodless “surgery” where highly focused radiation beams are aimed at the trigeminal nerve.
Is Radiosurgery or gamma knife traetment different from RFLG or glycerol injections or balloon compression for trigeminal neuralgia?
In principle it is the same nerve-destroying procedure. Gamma Knife radiosurgery subjects the trigeminal nerve to a highly focused beam of radiation which causes destruction.
In RFLG heat is used, in Glycerol injection an injection of glycerol is used, and in Balloon compression a balloon squeezes the ganglion to destroy it.
Is Gamma Knife a knife?
No, Gamma knife radiosurgery is not a knife, neither is it a surgery. Because the radiation beams are so focused and precise, it is called a knife, and the procedure a surgery.
What kind of radiation is used in radiosurgery for Trigeminal neuralgia treatment?
Radioactive Cobalt is most commonly used in Gamma knife radiosurgery.
What is a linear Accelerator, and what is its role in Trigeminal Neuralgia?
It is actually a device that is used for radiotherapy of tumors including those in the brain. This uses radiation similar to X-rays. This may also be used for radiosurgery.
How is the Gamma knife radiosurgery procedure performed?
A frame is attached to the patient’s head, an MRI is obtained to precisely locate the nerve root of the trigeminal nerve, and using a computer algorithm, radiation is focused on the nerve.
Is Radiosurgery or gamma knife treatment painful?
No. Only the part where the frame is attached is relatively painful. The actual radiation is painless and bloodless.
How long does the gamma knife radiosurgery procedure last?
Generally about four to six hours.
Is there need for anaesthesia for Gamma Knife radiosurgery?
Generally, no.
What are the results of Gamma knife radiosurgery treatment for Trigeminal neuralgia?
Like most other procedures, it depends on the centre and experience. Gamma Knife works best for type 1 or classical Trigeminal neuralgia. It also works best if it is the first procedure tried. This is an expensive option, and may need repeat procedures.
Is the pain relief after Gamma knife Radiosurgery immediate?
No, almost always it is delayed by a few months. That is why a repeat procedure if necessary, is to be done after about six months. Long-term results are yet unknown.
What are the advantages of Gamma Knife treatment for Trigeminal neuralgia?
It has relatively few side-effects, certainly at a lower incidence than other nerve destroying procedures. Serious complications are quite infrequent.
What are the main drawbacks?
Cost seems to be the most major drawback, especially considering the fact that repeat procedures may be needed. Generally, only about 50% patients are pain-free after the treatment. The chances of needing a further one or more sittings of gamma knife or other procedures is the major setback.
What is the best treatment offering a permanent cure for Trigeminal neuralgia?
Microvascular decompression surgery is the only treatment which is nerve-preserving (not nerve -destroying) and which has a great potential for permanent cure. Dr Jaydev Panchwagh has operated on more than thousand patients with trigeminal neuralgia and has an excellent pain-relief rate of about 98%.