Treating Trigeminal Neuralgia With Stereotactic Radiosurgery via CyberKnife: David Huang, MD

WATCH TIME: 6 minutes

"Patients with trigeminal neuralgia have some type of abnormal signaling going through the fifth cranial nerve or the trigeminal nerve. One of the options we offer is stereotactic radiosurgery, and that can be done with CyberKnife system. Most patients have improvement of pain with the system and some even have complete relief of pain. While the risks of numbness exist, most patients who are desperate for relief from the pain are willing to accept this minor risk for the chance of improved quality of life."

National Trigeminal Neuralgia Awareness Day, held October 7, 2023, is a day in the clinical and patient community dedicated towards raising awareness on trigeminal neuralgia (TN). TN is a chronic pain condition that impacts a craniofacial nerve that is primarily responsible for transmitting sensations from the face to the brain.¹ Treatment for the condition usually starts with medication to block the pain signals sent to the brain although some medications become less effective over time, and some can have severe adverse effects. Thus, more alternative treatments for patients including injections, radiofrequency, balloon compression, surgery, or radiosurgery may be needed.

In March 2022, long-term follow-up data from a study of 84 patients with TN showed 72% continued to experience pain relief 10 years after receiving image-guided robotic radiosurgery treatments delivered with the CyberKnife system (developed by Accuray).¹ The study evaluated the safety and efficacy of CyberKnife radiosurgery in patients with TN with a prescription dose of 60 Gy was delivered in a single fraction to a 6-mm segment of the nerve. The same dose was delivered if a second treatment was needed and over time was reduced to 45 Gy. All patients took medications for an average of 4.3 years before treatment with CyberKnife.

Recently, David Huang, MD, a radiation oncologist at Cooperman Barnabas Medical Center, sat down in an interview with NeurologyLive® to discuss the typical symptoms and challenges associated with diagnosing TN. He also talked about how stereotactic radiosurgery using CyberKnife provides an innovative treatment for patients with TN. He shared more on how the CyberKnife system works and when it's a good time for a patent with TN to have the surgery completed. Additionally, he spoke about the benefits and risks of using stereotactic radiosurgery to treat TN, and how patients with TN perceive the risks of the surgery.

REFERENCES
1. 10-Year Data Shows Accuray CyberKnife System Provides Long-Lasting Relief of the Excruciating Pain Caused by Trigeminal Neuralgia. News Release. Published March 31, 2022. Accessed November 7, 2023. https://investors.accuray.com/news-releases/news-release-details/10-year-data-shows-accuray-cyberknifer-system-provides-long