CURRENT CONCEPTS IN RADIOTHERAPY FOR BENIGN DISORDERS

CurrentConceptsinRadiotherapyforBenignDisorders1-0-25kapak

Trigeminal Neuralgia

Ferrat DİNÇOĞLANa , Galip Doğukan DOĞRUa
aUniversity of Health Sciences Gülhane Faculty of Medicine, Department of Radiation Oncology, Ankara, Türkiye

Dinçoğlan F, Doğru GD. Trigeminal neuralgia. In: Uysal B, Gamsız H, eds. Current Concepts in Radiotherapy for Benign Disorders. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.57-60.

ABSTRACT
Trigeminal neuralgia (TN) is a syndrome characterized by episodic, unilateral electric shock-like pain in the trigeminal nerve, triggered by stimuli, with sudden onset and termination. TN is a rare pathology with an incidence of 4-13 per 100,000 people per year. It is more common in women than in men. Most cases of TN are caused by compression of the trigeminal nerve root, usually by an abnormal section of a vessel. TN is divided into three types: classic TN, secondary TN and idiopathic TN. Classic TN includes cases caused by vascular compression. Secondary TN results from a cause such as multiple sclerosis or a tumor. TN without a specific cause is categorized as idiopathic. Antiepileptic drugs such as carbamazepine are used as first-line treatment. Surgical procedures or radiotherapy are recommended for patients refractory to medical treatment. Long-term follow-up shows good results for pain in patients who undergo stereotactic radiosurgery (SRS).

Keywords: Trigeminal neuralgia; radiotherapy; stereotactic radiosurgery

Referanslar

  1. Antonini G, Di Pasquale A, Cruccu G, et al. Magnetic resonance imaging contribution for diagnosing symptomatic neurovascular contact in classical trigeminal neuralgia: a blinded case-control study and meta-analysis. Pain. 2014;155:1464-71. [Crossref]  [PubMed]
  2. Maarbjerg S, Gozalov A, Olesen J, et al. Trigeminal neuralgia-a prospective systematic study of clinical characteristics in 158 patients. Headache. 2014; 54:1574-82. [Crossref]  [PubMed]
  3. Guardiani E, Sadoughi B, Blitzer A, et al. A new treatment paradigm for trigeminal neuralgia using Botulinum toxin type A. Laryngoscope. 2014;124:413-7. [Crossref]  [PubMed]
  4. Jannetta PJ. Microsurgical management of trigeminal neuralgia. Arch Neurol. 1985;42:800. [Crossref]  [PubMed]
  5. Kanpolat Y, Ugur HC. Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurgery. 2005;57:E601. [Crossref]  [PubMed]
  6. Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124:2347-60. [Crossref]  [PubMed]
  7. Love S, Hilton DA, Coakham HB. Central demyelination of the vth nerve root in trigeminal neuralgia associated with vascular compression. Brain Pathol. 1998;8:1. [Crossref]  [PubMed]  [PMC]
  8. Hilton DA, Love S, Gradidge T, Coakham HB. Pathological findings associated with trigeminal neuralgia caused by vascular compression. Neurosurgery. 1994;35:299. [Crossref]  [PubMed]
  9. Pope JE, Narouze S. Orofacial pain. In: Essentials of Pain Medicine. 3rd ed. W.B. Saunders; 2011. p.283-93. [Crossref]
  10. Ritter PM, Friedman WA, Bhasin RR. The surgical treatment of trigeminal neuralgia: overview and experience at the University of Florida. J Neurosci Nurs. 2009;41(4):211-4; quiz 215-6. [Crossref]
  11. Ghislain B, Rabinstein AA, Braksick SA. Etiologies and Utility of Diagnostic Tests in Trigeminal Neuropathy. Mayo Clin Proc. 2022;97:1318. [Crossref]  [PubMed]
  12. Maarbjerg S, Gozalov A, Olesen J, Bendtsen L. Trigeminal neuralgia--a prospective systematic study of clinical characteristics in 158 patients. Headache. 2014;54:1574. [Crossref]  [PubMed]
  13. Fleetwood IG, Innes AM, Hansen SR, Steinberg GK. Familial trigeminal neuralgia. Case report and review of the literature. J Neurosurg. 2001;95:513. [Crossref]  [PubMed]
  14. Panchagnula S, Sularz AK, Kahle KT. Familial Trigeminal Neuralgia Cases Implicate Genetic Factors in Disease pathogenesis. JAMA Neurol. 2019;76:9. [Crossref]  [PubMed]
  15. MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. The incidence and lifetime prevalence of neurological disorders in a prospective communitybased study in the UK. Brain. 2000;123(pt 4):665. [Crossref]  [PubMed]
  16. Katusic S, Williams DB, Beard CM, Bergstralh EJ, Kurland LT. Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984. Neuroepidemiology. 1991;10(5-6):276-81. [Crossref]  [PubMed]
  17. Childs AM, Meaney JF, Ferrie CD, Holland PC. Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports. Arch Dis Child. 2000;82.311. [Crossref]  [PubMed]  [PMC]
  18. Headache Classification Committee of the International Headache Society. The international classification of head- ache disorders, 3rd ed (beta version). Cephalalgia. 2013:33(9):629-808. [Crossref]  [PubMed]
  19. Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ. 2014;348:g474. [Crossref]  [PubMed]
  20. Sjaastad O, Pareja JA, Zukerman E, et al. Trigeminal neuralgia. Clinical manifestations of first division involvement. Headache. 1997;37:346. [Crossref]  [PubMed]
  21. Pareja JA, Barón M, Gili P, et al. Objective assessment of autonomic signs during triggered first division trigeminal neuralgia. Cephalalgia. 2002;22:251. [Crossref]  [PubMed]
  22. Bendtsen L, Zakrzewska JM, Abbott J, et al. European Academy of Neurology guideline on trigeminal neuralgia. Eur J Neurol. 2019;26:831. [Crossref]  [PubMed]
  23. Nurmikko TJ, Eldridge PR. Trigeminal neuralgia-pathophysiology, diagnosis and current treatment. Br J Anaesth. 2001;87:117-32. [Crossref]  [PubMed]
  24. Lucas JT Jr, Nida AM, Isom S, et al. predictive nomogram for the durability of pain relief from gamma knife radiation surgery in the treatment of trigeminal neuralgia. Int J Radiat Oncol Biol Phys. 2014;89:120-6. [Crossref]  [PubMed]  [PMC]
  25. Kondziolka D, Zorro O, Lobato-Polo J, et al. Gamma Knife stereotactic radiosur-gery for idiopathic trigeminal neuralgia. J Neurosurg. 2010;112:758-65. [Crossref]  [PubMed]
  26. Young B, Shivazad A, Kryscio RJ, et al. Long-term outcome of high-dose gamma knife surgery in treatment of trigeminal neuralgia. J Neurosurg. 2013;119:1166-75. [Crossref]  [PubMed]
  27. Flickinger JC, Pollock BE, Kondziolka D, Phuong LK, Foote RL, Stafford SL, et al. Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? A prospective double-blind, randomized study. Int J Radiat Oncol Biol Phys. 2001;51(2):449-54. [Crossref]  [PubMed]
  28. Kotecha R, Kotecha R, Modugula S, Murphy ES, Jones M, Kotecha R, et al.Trigeminal Neuralgia Treated With Stereotactic Radiosurgery: The Effect of Dose Escalation on pain Control and Treatment Outcomes. Int J Radiat Oncol Biol Phys. 2016;96(1):142-8. [Crossref]  [PubMed]
  29. Herman JM, Petit JH, Amin P, et al. Repeat gamma knife radiosurgery for refractory or recurrent trigeminal neuralgia: treatment outcomes and quality-of-life assessment. Int J Radiat Oncol Biol Phys. 2004;59:112-6. [Crossref]  [PubMed]