Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America

Detalhes bibliográficos
Autor(a) principal: Constanzo,Felipe
Data de Publicação: 2019
Outros Autores: Silva,Rodrigo Souza da, de Almeida,Daniel Benzecry, Ferragut,Maria Alice, Coelho Neto,Mauricio, Toledo,Hugo Veroneze, Ramina,Ricardo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos de neuro-psiquiatria (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000400232
Resumo: ABSTRACT Gamma Knife® radiosurgery (GKRS) for trigeminal neuralgia is an effective treatment with at least a 50% reduction of pain in 75-95% of patients. Objective: To present the first series of patients treated for trigeminal neuralgia using GKRS in Latin America. Methods: Retrospective analysis. Analysis consisted of time to improvement of symptoms, best Barrow Neurological Institute scale (BNI) score after procedure, time without pain, time to recurrence and post-procedural hypoesthesia. Results: Nineteen cases of classical trigeminal neuralgia were analyzed and three cases of symptomatic trigeminal neuralgia were described. Mean time from symptom onset to radiosurgery was 99.6 months, and 78.9% of patients had undergone invasive procedures before treatment. Patients were followed for a mean of 21.7 months. BNI I was achieved in 36.8%, IIIa in 21.1%, IIIb in 21.1%, IV in 5.3% and V in 15.7%. New hypoesthesia developed in 12.1% patients, which was associated with achieving BNI I after the procedure (p < 0.05). Time from diagnosis to GKRS was higher in patients who failed to achieve BNI I (143 vs. 76 months). The distance from the root entry zone in patients who achieved BNI I was greater than patients who did not (1.94 vs. 1.14 mm). Mean distance from the root entry zone in patients with new hypoesthesia was 2.85 mm vs. 1.06 mm (p = 0.06). Conclusion: Clinical response to GKRS is related to the time between diagnosis and procedure, thus its indication should be considered early in the management of these patients.
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spelling Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin AmericaTrigeminal neuralgiaradiosurgeryneuropathic painABSTRACT Gamma Knife® radiosurgery (GKRS) for trigeminal neuralgia is an effective treatment with at least a 50% reduction of pain in 75-95% of patients. Objective: To present the first series of patients treated for trigeminal neuralgia using GKRS in Latin America. Methods: Retrospective analysis. Analysis consisted of time to improvement of symptoms, best Barrow Neurological Institute scale (BNI) score after procedure, time without pain, time to recurrence and post-procedural hypoesthesia. Results: Nineteen cases of classical trigeminal neuralgia were analyzed and three cases of symptomatic trigeminal neuralgia were described. Mean time from symptom onset to radiosurgery was 99.6 months, and 78.9% of patients had undergone invasive procedures before treatment. Patients were followed for a mean of 21.7 months. BNI I was achieved in 36.8%, IIIa in 21.1%, IIIb in 21.1%, IV in 5.3% and V in 15.7%. New hypoesthesia developed in 12.1% patients, which was associated with achieving BNI I after the procedure (p < 0.05). Time from diagnosis to GKRS was higher in patients who failed to achieve BNI I (143 vs. 76 months). The distance from the root entry zone in patients who achieved BNI I was greater than patients who did not (1.94 vs. 1.14 mm). Mean distance from the root entry zone in patients with new hypoesthesia was 2.85 mm vs. 1.06 mm (p = 0.06). Conclusion: Clinical response to GKRS is related to the time between diagnosis and procedure, thus its indication should be considered early in the management of these patients.Academia Brasileira de Neurologia - ABNEURO2019-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000400232Arquivos de Neuro-Psiquiatria v.77 n.4 2019reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/0004-282x20190027info:eu-repo/semantics/openAccessConstanzo,FelipeSilva,Rodrigo Souza dade Almeida,Daniel BenzecryFerragut,Maria AliceCoelho Neto,MauricioToledo,Hugo VeronezeRamina,Ricardoeng2019-05-08T00:00:00Zoai:scielo:S0004-282X2019000400232Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2019-05-08T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse
dc.title.none.fl_str_mv Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
title Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
spellingShingle Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
Constanzo,Felipe
Trigeminal neuralgia
radiosurgery
neuropathic pain
title_short Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
title_full Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
title_fullStr Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
title_full_unstemmed Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
title_sort Gamma knife radiosurgery for trigeminal neuralgia: first case series from Latin America
author Constanzo,Felipe
author_facet Constanzo,Felipe
Silva,Rodrigo Souza da
de Almeida,Daniel Benzecry
Ferragut,Maria Alice
Coelho Neto,Mauricio
Toledo,Hugo Veroneze
Ramina,Ricardo
author_role author
author2 Silva,Rodrigo Souza da
de Almeida,Daniel Benzecry
Ferragut,Maria Alice
Coelho Neto,Mauricio
Toledo,Hugo Veroneze
Ramina,Ricardo
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Constanzo,Felipe
Silva,Rodrigo Souza da
de Almeida,Daniel Benzecry
Ferragut,Maria Alice
Coelho Neto,Mauricio
Toledo,Hugo Veroneze
Ramina,Ricardo
dc.subject.por.fl_str_mv Trigeminal neuralgia
radiosurgery
neuropathic pain
topic Trigeminal neuralgia
radiosurgery
neuropathic pain
description ABSTRACT Gamma Knife® radiosurgery (GKRS) for trigeminal neuralgia is an effective treatment with at least a 50% reduction of pain in 75-95% of patients. Objective: To present the first series of patients treated for trigeminal neuralgia using GKRS in Latin America. Methods: Retrospective analysis. Analysis consisted of time to improvement of symptoms, best Barrow Neurological Institute scale (BNI) score after procedure, time without pain, time to recurrence and post-procedural hypoesthesia. Results: Nineteen cases of classical trigeminal neuralgia were analyzed and three cases of symptomatic trigeminal neuralgia were described. Mean time from symptom onset to radiosurgery was 99.6 months, and 78.9% of patients had undergone invasive procedures before treatment. Patients were followed for a mean of 21.7 months. BNI I was achieved in 36.8%, IIIa in 21.1%, IIIb in 21.1%, IV in 5.3% and V in 15.7%. New hypoesthesia developed in 12.1% patients, which was associated with achieving BNI I after the procedure (p < 0.05). Time from diagnosis to GKRS was higher in patients who failed to achieve BNI I (143 vs. 76 months). The distance from the root entry zone in patients who achieved BNI I was greater than patients who did not (1.94 vs. 1.14 mm). Mean distance from the root entry zone in patients with new hypoesthesia was 2.85 mm vs. 1.06 mm (p = 0.06). Conclusion: Clinical response to GKRS is related to the time between diagnosis and procedure, thus its indication should be considered early in the management of these patients.
publishDate 2019
dc.date.none.fl_str_mv 2019-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000400232
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000400232
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0004-282x20190027
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
dc.source.none.fl_str_mv Arquivos de Neuro-Psiquiatria v.77 n.4 2019
reponame:Arquivos de neuro-psiquiatria (Online)
instname:Academia Brasileira de Neurologia
instacron:ABNEURO
instname_str Academia Brasileira de Neurologia
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reponame_str Arquivos de neuro-psiquiatria (Online)
collection Arquivos de neuro-psiquiatria (Online)
repository.name.fl_str_mv Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia
repository.mail.fl_str_mv ||revista.arquivos@abneuro.org
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