{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:50:19Z","timestamp":1783774219139,"version":"3.55.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The purpose of this study was to assess the long-term outcome achieved after repeat Gamma Knife surgery (GKS) for trigeminal neuralgia (TN) using a uniform treatment plan.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between 1985 and 2010, 53 patients underwent repeat GKS for refractory TN. In the initial GKS, which involved targeting the root entry zone of the trigeminal nerve, a maximal dose of 80 Gy was used with a 4-mm collimator so that the 50% isodose line abutted the pons. In the second GKS, the treatment plan consisted of a 70-Gy dose directed at a target 4\u20135 mm distal to the first target on the trigeminal nerve. The mean follow-up duration in these patients was 42 months. Outcomes were defined using the Marseille scale: excellent (Class I or II, no pain with or without medications), good (Class III or IV, \u2265 50% relief), and poor (Class V, &lt; 50% relief).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Trigeminal neuralgia pain was controlled (\u2265 50% improvement with or without medications) after repeat GKS in 70% of patients at 1 year, 50% at 3 years, 50% at 5 years, and 50% at 10 years, as defined by a Kaplan-Meier analysis. A correlation was found between facial numbness and pain relief (p = 0.047). No difference was found between patients with Type 1 TN and those with Type 2 TN, and there was no correlation between the best relief obtained and long-term durability of relief from pain. Twenty-two patients (47.8%) described their trigeminal dysfunction in the following manner: numbness (45.6%), dry eye (10.9%), taste change (8.7%), or jaw weakness (2.2%). In only 8.7% of cases did the patient experience facial numbness that was regarded as bothersome.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Repeat GKS for TN at the doses used provides substantial long-term relief. Treatment failure occurred up to 28 months after the second GKS. Facial numbness correlated with more durable pain relief after repeat GKS in this series.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.8.gks101075","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T01:09:47Z","timestamp":1542330587000},"page":"178-183","source":"Crossref","is-referenced-by-count":24,"title":["Repeat Gamma Knife surgery for trigeminal neuralgia: long-term results"],"prefix":"10.3171","volume":"113","author":[{"given":"Brent Y.","family":"Kimball","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Sorenson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee and the Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee and the Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1130178","series-title":"N Engl J Med","first-page":"1077","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker","year":"1996"},{"key":"b2-1130178","series-title":"J Neurosurg","first-page":"848","article-title":"Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia","volume":"100","author":"Brisman","year":"2004"},{"key":"b3-1130178","series-title":"Stereotact Funct Neurosurg","first-page":"43","article-title":"Repeat gamma knife radiosurgery for trigeminal neuralgia","volume":"81","author":"Brisman","year":"2003"},{"key":"b4-1130178","series-title":"Neurosurg Clin N Am","first-page":"53","article-title":"Percutaneous balloon compression of the trigeminal nerve","volume":"8","author":"Brown","year":"1997"},{"key":"b5-1130178","series-title":"Neurosurgery","first-page":"570","article-title":"Percutaneous trigeminal nerve compression for treatment of trigeminal neuralgia: results in 50 patients","volume":"32","author":"Brown","year":"1993"},{"key":"b6-1130178","series-title":"J Neurosurg","first-page":"35","article-title":"Long-term efficacy of microvascular decompression in trigeminal neuralgia","volume":"69","author":"Burchiel","year":"1988"},{"key":"b7-1130178","series-title":"Neurosurgery","first-page":"152","article-title":"On the natural history of trigeminal neuralgia","volume":"46","author":"Burchiel","year":"2000"},{"key":"b8-1130178","series-title":"J Neurosurg","first-page":"351","article-title":"Long-term outcomes of Gamma Knife radiosurgery for classic trigeminal neuralgia: implications of treatment and critical review of the literature. 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