伽玛刀治疗原发性三叉神经痛87例分析

目的 分析和评价伽玛刀治疗原发性三叉神经痛的疗效。方法 对87例原发性三又神经痛病人采用MRI定位，以患侧三又神经根为靶点，选用4mm准直器治疗，中心剂量为70—90Gy伽玛刀治疗。结果 随访6—67个月，疼痛完全缓解66例(75．9％)，疼痛大部分缓解18例(20．7％)，疼痛部分缓解2例(2．3％)，疼痛无缓解1例(1．1％)，其中2例(2．3％)疼痛完全缓解后复发，再次经伽玛刀治疗后疼痛完全缓解。2例(2．3％)发生患侧面部麻木。结论 伽玛刀治疗原发性三叉神经痛创伤小、并发症少、疗效好，复发后再次行伽玛刀治疗疼痛可缓解。远期疗效有待评价。

Treatment of idiopathic trigeminal neuralgia with gamma knife: a report of 87 cases

Objective To evaluate the therapeutic efficacy of gamma knife for the treatment of idiopathic trigeminal neuralgia Methods An analysis of 87 cases with idiopathic trigeminal neuralgia treated by gamma knife in our department in the past 5 years was performed In all cases, 4 mm isocenter was targeted at the proximal nerve at the root entry zone located by MRI The target dose varied from 70-90 Gy Results After a follow up of 6-67 months, complete relief of pain occurred in 66 patients (75 9%), 50%-90% relief in 18(20 7%), relief less than 50% in 2(2 3%) but no relief in 1(1 1%) Repeated radiosurgery was performed in 2 patients (2 3%) with recurrent pain After the second radiosurgical procedure, complete relief of pain was found in the 2 patients Two patients(2 3%) experienced facial numbness after radiosurgical procedure Conclusion Gamma knife radiosurgery is a minimally invasive technique for the treatment of trigeminal neuralgia with few complications Repeated radiosurgical procedure may result in relief of pain, but the long term outcome of gamma knife surgery for trigeminal neuralgia needs to be further studied