However, this is challenged by the following first case presentation of a patient with atypical trigeminal neuralgia who developed a severe complication after a single GLOA procedure.
Under the clinical suspicion of triggered atypical trigeminal neuralgia by an external oral and maxillofacial surgeon, she received one transoral GLOA at the left GCS (ganglion cervicale superius) in a private oral and maxillofacial practice without using an analgetic specific medication (without a documented reason) before.
The desire of patients suffering from chronic orofacial pain syndromes (i.e., typical and atypical trigeminal neuralgia) for immediate pain relief has led to the introduction of first-line treatment options including drug therapy with anticonvulsants or analgetics (i.e., carbamazepine and oxacarbamazepine) and injection of local anesthetics close to sympathetic ganglia .
Atypical trigeminal neuralgia was excluded from the multicenter studies that established the gamma knife's benefits in patients with facial pain, he noted.
"We firmly believe the gamma knife is an effective treatment option for people with atypical trigeminal neuralgia. The thing to keep in mind is that the time to pain relief may be longer and the duration of relief shorter than in patients treated for classic trigeminal neuralgia," said Dr.