Stereotactic radiosurgery for trigeminal neuralgia

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 19 sources, which was discussed by the committee. The evidence included 4 systematic reviews, 1 randomised controlled trial, 2 case series, 1 cohort study and 11 case reports. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: pain relief, improved quality of life, and need for retreatment.

The professional experts and the committee considered the key safety outcomes to be: dysaesthesia, damage to nerves and other surrounding structures, and radiation-induced malignancy.

NICE received 1 submission from a patient organisation.

The committee was pleased to receive a detailed submission from a patient organisation, which outlined how trigeminal neuralgia can adversely affect the lives of people with multiple sclerosis. It noted the positive benefit that some people with trigeminal neuralgia secondary to multiple sclerosis have had from this procedure.

The committee noted that trigeminal neuralgia is a very painful condition that can negatively affect a person's quality of life.

The committee noted that some people experience relapse, but retreatment is possible.

There are different devices available for the procedure, which use different targeting techniques.

None of the evidence considered by the committee used proton beam therapy.