Cyberknife treatment for Trigeminal neuralgia

Cyberknife treatment for Trigeminal neuralgia

Trigeminal neuralgia is a neurophatic disorder also known as tic doulourex or prosopalgia. This pain originates in one of the three trigeminal nerves, T1, T2, and T3 and possibly with cranial nerve V, a mixed cranial nerve responsible for sensory and motor functions of the face. Episodes of severe or intense facial pain characterize it. Pain may last from a few seconds to several minutes or hours and may occur in cycles with remissions that may last for months or years. Ten to twenty percent of the cases report bilateral pain or occurring on both sides, manifesting pain in any or all of the following areas: ears, lips, nose, eyes, cheeks, jaw, teeth, along side of the face and sometimes the left index finger. Patients describe the pain sensation as a sensitive area that even the lightest touch and air current can trigger it. Factors like high pitched sounds, loud noises, crowds or concerts and activities like chewing and talking can aggravate the said condition. The attacks are usually described as a feeling of being stabbed with electric shocks, burning, crush, shooting pain that may eventually be intractable over a period of time. No reported incident happened when a patient is asleep. This remains a mystery for physicians. This condition is more prevalent among females aging 50 and older. A variant of trigeminal neuralgia has also been discovered. It is called the atypical trigeminal neuralgia or trigeminal neuralgia type 2. They experience severe, underlying, migraine-like pain combined to shock-like sensation. Theories state that this condition is brought about by the compression of the superior cerebellar artery against the trigeminal nerve. Such compression may damage the myelin sheath that leads to nerve's hyper functioning. This then causes the pain attacks. Some researches also say that this condition may be related to multiple sclerosis which damages either the trigeminal nerve or other related brain parts. Till to this day, no apparent or specific cause as been identified. It remains to be idiopathic or with unknown cause. It has no clear physical or laboratory diagnostic procedure applicable. Thus, it is usually misdiagnosed. A number of medications may be given to patient suffering this condition. These include anticonvulsant drugs like carbamazepine and baclofen; low doses of antidepressants like amytriptiline for treating neuropathic pain; Botox may also be injected into the nerve by a physician to adapt with patient's facial pains and needs. Opiates like morphines and oxycodone can also be prescribed for treating neuropathic pain. Other than the mentioned medications, procedures like surgery and stereotactic radiosurgery that maybe GammaKnife or CyberKnife, are the treatments for trigeminal neuralgia.

Prior to any procedure, a person must undergo MRI with giving close attention to the posterior fossa. This is done to rule out other possible causes of trigeminal nerve compression. Surgery is done by ablation, gasserian ganglion and retrogasserian ablative procedures and craniotomy. This will then followed by a stereotactic surgery. This may either be GammaKnife or CyberKnife treatment for trigeminal neuralgia.

Stereotactic surgery is done by delivering a high dose and prcised ionizing radiation at a target inside the brain. One of which is the GammaKnife. Several reports have been documented that this procedure showed efficacy in dealing with treating the condition. Another of which is CyberKnife. It is non-invasive, no scalpel, sedation and screws are used for the procedure. No scars are formed. It makes use of individualized treatment plan for every patient, depending on the patient's tumor size, shape and location. This procedure is painless and projects no risk of complications like hemorrhage or excessive blood loss. No post-recovery period is needed for the procedure. It can be done in an out-patient basis. Thus, patient can get back to his usual lifestyle afterwards. And for state-of-the-art treatment for trigeminal neuralgia, it is the Colorado CyberKnife provides the world's effective one for it. They are the world's first CyberKnife VSI facility. They have shown effective cure to cancer patients, making them known in the world of oncology.

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