Side Effects of Gamma Knife Radiation for Trigeminal Neuralgia

As you are exploring your treatment options for trigeminal neuralgia, it’s important to understand the possible side effects of each option. This will help you make an informed decision about how you would like to proceed, which is an important part of the treatment planning process.

The following information focuses on Gamma Knife radiosurgery to treat trigeminal neuralgia. Gamma Knife Radiosurgery is an effective way to treat trigeminal neuralgia without any surgery or hospital stay, but many patients are unfamiliar with how it works and what to expect afterward. Read on to learn more about how Gamma Knife radiosurgery can be used to treat your condition, including what side effects may occur.

Trigeminal Neuralgia and its Symptoms

Before discussing how Gamma Knife radiosurgery works, it can be helpful to have an understanding of the underlying cause of trigeminal neuralgia. As you’re well aware, there is one defining characteristic of trigeminal neuralgia: pain. The condition is typically diagnosed by assessing your symptoms and ruling out other conditions, which can be a difficult process. The good news is that clinicians and researchers have uncovered the most common underlying cause of the pain, which means it can also be treated.

The pain of trigeminal neuralgia is limited to the face, which is innervated by the trigeminal nerve. The pain often comes and goes, but many patients find the attacks occur more frequently and last longer with time. During an attack, normal daily activities (like smiling, talking and brushing teeth) can be excruciatingly painful. The pain may feel like electric shocks, stabbing knives or a dull ache.

More often than not, the culprit is an aberrant blood vessel within the brain putting pressure on the trigeminal nerve. This essentially causes the nerve to be overstimulated and misfire, leading to inappropriate pain signals during normal activities. Rarely, the cause may be a tumor or other structure impinging on the nerve. In even fewer cases, the underlying cause cannot be determined.

Unfortunately, all patients with trigeminal neuralgia experience symptoms. This is because trigeminal neuralgia is a diagnosis based on your symptoms, followed by the exclusion of other conditions. There are no diagnostic tests or imaging that can test for trigeminal neuralgia.

Understanding Gamma Knife Radiosurgery

You may not be familiar with Gamma Knife radiosurgery. Though it sounds like a surgical procedure, it’s not. Rather, it’s an advanced form of radiation therapy that doesn’t involve any scalpels or incisions at all. During the procedure, nearly 200 individual beams of low-dose radiation combine to treat an area as precise as 0.15 mm – the width of a single human hair. This enables your doctor to treat a very small area while sparing surrounding tissues. That means fewer unpleasant side effects than other forms of radiation therapy.

Gamma Knife radiosurgery has been proven an effective, minimally invasive treatment for trigeminal neuralgia. Studies have shown that 75-80% of patients have good to excellent pain relief after treatment. Gamma Knife radiosurgery is also used to treat medically refractory trigeminal neuralgia, or trigeminal neuralgia that doesn’t respond to other treatments. These treatments could include medication and/or surgery.

Because it’s a minimally invasive procedure, you don’t have to stay overnight in the hospital following Gamma Knife radiosurgery. The recovery is generally mild, and most patients are back to normal activities (including work) within a day or two. However, some patients will experience the side effects outlined below.Side Effects of Gamma Knife Radiation for Trigeminal Neuralgia

Immediately following Gamma Knife radiosurgery, most patients feel tired for a day or two. During this time, you may also have a headache and/or nausea. Again, these symptoms are typically transient and mild. However, your doctor can write a prescription for medication to help you feel more comfortable if necessary.

Approximately six months after Gamma Knife radiosurgery, some patients experience a delayed swelling of the brain. You may start to have headaches, and your doctor will monitor you at follow-up visits for any changes. Should this occur, your doctor will prescribe medicine to resolve the issue. No further treatment is typically necessary.

It’s also important to know that 5-10% of trigeminal neuralgia patients experience delayed facial numbness following Gamma Knife radiosurgery. This is because the facial nerve is damaged during treatment, which is an even greater risk following trigeminal neuralgia surgery. It is important that you discuss this with your doctor and consider the possibility of lasting numbness as a side effect of the procedure, which may or may not resolve with time.

Discuss Your Case with Your Doctor

Though it’s helpful to understand what many patients experience, it’s impossible to predict what your Gamma Knife radiation recovery is going to be like. Your doctor is the person who knows your individual condition best, and he or she can discuss your expected treatment outcome. Part of the treatment-planning process involves weighing benefits and risks of all available options, including the side effects of Gamma Knife radiosurgery for trigeminal neuralgia.

As you move forward, continue to educate yourself about your condition and treatment options. Trigeminal neuralgia has historically been difficult to diagnose and manage, but doctors understand the condition better than ever. You have options, and many people have undergone treatment and seen relief from the pain. Be sure to continue the conversation with your doctor, so he or she can help answer any questions you have and set your mind at ease.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

Patient liaisons explain Gamma Knife surgery cost, outcomes, etc.