Medical Technology Directory

medical technology evaluations at your fingertips

Comparative Effectiveness Review of Stereotactic Radiosurgery for Trigeminal Neuralgia

September 26, 2019

Health Problem: Trigeminal neuralgia (TGN) is a neurological condition that can cause severe pain that cannot be controlled with medication in some patients. Women are twice as likely to be affected as men and the disease most often presents after age 40 years, with a typical age of onset between 60 to 70 years.

Technology Description: Stereotactic radiosurgery (SRS) is a therapeutic technique that focuses high dosages of radiation onto small, precisely defined targets in the brain, such as a segment of the thalamus or globus pallidus. In SRS, a head frame with trackable markers is securely attached to the head of the patient who then undergoes high-resolution magnetic resonance imaging and/or computed tomography scans. Information from imaging is used to identify the target for intensive radiation treatment and the head frame is used to guide targeting of radiation to the site of treatment.

Controversy: Despite use of high-resolution imaging and target tracking, errors can occur in target identification and focusing of radiation beams during SRS, causing complications that may be irreversible.

Key Questions:

  • Is SRS an effective treatment for TGN?
  • How does SRS compare with invasive and minimally invasive surgical treatments for TGN?
  • Is SRS safe for the treatment of TGN?
  • Have definitive patient selection criteria been established for SRS for the treatment of TGN?