Background: Patients with typical trigeminal neuralgia were treated by one neurosurgeon with either microvascular decompression (MVD) or Gamma Knife radiosurgery (GKRS) and were prospectively evaluated with a uniform protocol. Method: GKRS was done with 75 Gy maximum to the cisternal trigeminal nerve near the pons. MVD was done without cauterizing or cutting the trigeminal nerve. Results: Twenty-four patients were treated with MVD and 61 with GKRS. Complete pain relief (no pain no medicines) occurred at 12 and 18 months in 68 and 68% of patients treated with MVD and 58 and 24% with GKRS (p = 0.089), and ≧90% pain relief (with or without medicine) at 12 and 18 months in 90 and 78% with MVD and 75 and 48% with GKRS (p = 0.171). There were no permanent complications. Conclusion: Although many trigeminal neuralgia patients treated with either MVD or GKRS have pain relief, MVD is more likely than GKRS to result in complete pain relief.

Keywords:
Trigeminal neuralgia, Microvascular decompression, Gamma Knife radiosurgery
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© 2007 S. Karger AG, Basel
2006
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