{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:43:52Z","timestamp":1793605432775,"version":"4.5.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Suppl","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Among patients with multiple sclerosis (MS) there is a high incidence of trigeminal neuralgia (TN), and outcomes after treatment seem inferior to those in patients suffering from idiopathic TN. The goal of this study was to evaluate clinical outcomes in patients with MS-related TN after Gamma Knife surgery (GKS) and compare them with those obtained using percutaneous retrogasserian glycerol rhizotomy (PRGR).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors retrospectively reviewed the charts of 45 patients with MS-related TN. The first procedure undertaken was GKS in 27 patients and PRGR in 18 patients. Pain had been present for a median of 60 months (range 12\u2013276 months) in patients who underwent GKS and 48 months (range 12\u2013240 months) in patients who underwent PRGR. The following outcome measures were assessed in both groups of patients: pain relief (using the Barrow Neurological Institute [BNI] Pain Scale), procedure-related morbidity, time to pain relief and recurrence, and subsequent procedures that were performed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The median duration of follow-up was 39 months (range 13\u201369 months) in the GKS group and 38 months (range 2\u201375 months) in the PRGR group. Reasonable pain control (BNI Pain Scale Scores I\u2013IIIb) was noted in 22 patients (81.5%) who underwent GKS and in 18 patients (100%) who underwent PRGR. For patients who underwent GKS, the median time to pain relief was 6 months; for those who underwent PRGR, pain relief was immediate. In the GKS group12 patients required subsequent procedures (3 patients for absence of response and 9 patients for pain recurrence), whereas in the PRGR group 6 patients required subsequent procedures (all for pain recurrence). As of the last follow-up, complete or reasonable pain control was finally achieved in 23 patients (85.2%) in the GKS group and in 16 patients (88.9%) in the PRGR group. The morbidity rate was 22.2% in the GKS group (all due to sensory loss and paresthesia) and 66.7% in the PRGR group (mostly hypalgesia, with 2 patients having corneal reflex loss and 1 patient suffering from meningitis).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Both GKS and PRGR are satisfactory strategies for treating MS-related TN. Gamma Knife surgery has a lower rate of sensory and overall morbidity than PRGR, but requires a delay before pain relief occurs. The authors propose that patients with extreme pain in need of fast relief should undergo PRGR. For other patients, both management strategies can lead to satisfactory pain relief, and the choice should be made based on patient preference and expectations.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.6.gks12987","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:55:40Z","timestamp":1542329740000},"page":"175-180","source":"Crossref","is-referenced-by-count":42,"title":["Comparative study of Gamma Knife surgery and percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis"],"prefix":"10.3171","volume":"117","author":[{"given":"David","family":"Mathieu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Effendi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"S\u00e9guin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1170175","series-title":"Arch Neurol","first-page":"219","article-title":"Percutaneous trigeminal rhizotomy. Treatment of trigeminal neuralgia secondary to multiple sclerosis","volume":"39","author":"Brett","year":"1982"},{"key":"b2-1170175","series-title":"Pain","first-page":"186","article-title":"Trigeminal neuralgia and pain related to multiple sclerosis","volume":"143","author":"Cruccu","year":"2009"},{"key":"b3-1170175","series-title":"Clin Neurol Neurosurg","first-page":"101","article-title":"Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment","volume":"114","author":"De Santi","year":"2012"},{"key":"b4-1170175","series-title":"Neurology","first-page":"1294","article-title":"Trigeminal neuralgia in multiple sclerosis","volume":"45","author":"Hooge","year":"1995"},{"key":"b5-1170175","series-title":"Stereotact Funct Neurosurg","first-page":"44","article-title":"Gamma knife radiosurgery for treatment of trigeminal neuralgia in multiple sclerosis patients","volume":"79","author":"Huang","year":"2002"},{"key":"b6-1170175","series-title":"Can J Neurol Sci","first-page":"78","article-title":"Trigeminal neuralgia: outcomes after gamma knife radiosurgery","volume":"36","author":"Knafo","year":"2009"},{"key":"b7-1170175","series-title":"Can J Neurol Sci","first-page":"137","article-title":"Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia","volume":"21","author":"Kondziolka","year":"1994"},{"key":"b8-1170175","series-title":"Arch Neurol","first-page":"1524","article-title":"Gamma knife radiosurgery for trigeminal neuralgia: results and expectations","volume":"55","author":"Kondziolka","year":"1998"},{"key":"b9-1170175","series-title":"Neuropathol Appl Neurobiol","first-page":"238","article-title":"Trigeminal neuralgia due to multiple sclerosis: ultrastructural findings in trigeminal rhizotomy specimens","volume":"27","author":"Love","year":"2001"},{"key":"b10-1170175","series-title":"Acta Neurochir (Wien)","first-page":"779","article-title":"Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis. Analysis of the potentially prognostic factors","volume":"154","author":"Montano","year":"2012"},{"key":"b11-1170175","series-title":"Neurosurgery","first-page":"537","article-title":"Percutaneous retrogasserian glycerol rhizotomy in the treatment of tic douloureux associated with multiple sclerosis","volume":"56","author":"Pickett","year":"2005"},{"key":"b12-1170175","series-title":"Surg Neurol","first-page":"358","article-title":"Microvascular decompression for trigeminal neuralgia in patients with multiple sclerosis","volume":"46","author":"Resnick","year":"1996"},{"key":"b13-1170175","series-title":"J Neurosurg","first-page":"913","article-title":"Prospective controlled trial of gamma knife surgery for essential trigeminal neuralgia","volume":"104","author":"R\u00e9gis","year":"2006"},{"key":"b14-1170175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1013","article-title":"Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute","volume":"47","author":"Rogers","year":"2000"},{"key":"b15-1170175","series-title":"J Neurosurg","first-page":"53","article-title":"Gamma Knife radiosurgery for trigeminal neuralgia: the impact of magnetic resonance imaging-detected vascular impingement of the affected nerve. Clinical article","volume":"113","author":"Sheehan","year":"2010"},{"issue":"Suppl","key":"b16-1170175","series-title":"J Neurosurg","first-page":"160","article-title":"Gamma Knife surgery for trigeminal neuralgia: a review of 450 consecutive cases. Clinical article","volume":"113","author":"Verheul","year":"2010"},{"key":"b17-1170175","series-title":"Neurology","first-page":"1149","article-title":"Gamma knife radiosurgery for multiple sclerosis-related trigeminal neuralgia","volume":"73","author":"Zorro","year":"2009"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p175.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p175.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p175.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T23:11:57Z","timestamp":1679872317000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p175.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":17,"journal-issue":{"issue":"Special_Suppl"},"URL":"https:\/\/doi.org\/10.3171\/2012.6.gks12987","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}