Download Trigeminal Neuralgia - Gamma Knife Center of the Pacific

S P R I N G
2 0 0 4
ON TARGET
IN THIS ISSUE
» Directors Greeting
G A M M A K N I F E C E N T E R Q U A R T E R LY N E W S L E T T E R
OF THE PACIFIC
» Trigeminal Neuralgia
» Factoid:
» Our First Patient
As of December 2003 there
were 193 Gamma Knife Units
installed worldwide. Here is
the breakdown:
» Dr. Leon K. Liem
» Factoid
Gamma Knife Center of the Pacific
2226 Liliha St., Level B1
Honolulu, HI 96817
Tel: 808 535-1579
Facsimile: 808 535-1540
Toll Free: 1 888 426-6215
[email protected]
Visit us at our website:
www.gammaknifehawaii.com
North America: 86
Japan: 41
China: 15
Other Asia: 19
Europe: 26
Middle East: 4
Latin America: 2
Neurosurgeons:
Maurice Nicholson M.D.
Leon Liem M.D.
Eric Oshiro M.D.
Warren Ishida M.D.
Gonzalo Chong M.D.
Jon Graham M.D.
Dan Donovan M.D.
Raymond Taniguchi M.D.
Alfred Bowles M.D.
Michon Morita M.D.
Radiation Oncologists:
Paul DeMare M.D.
Thanh Huynh M.D.
Laeton Pang M.D.
Winlove Suasin M.D.
Christina Liu M.D.
Trigeminal Neuralgia
Trigeminal neuralgia was one of the first conditions
successfully treated by the Gamma Knife. Initially the
treatment target was the gasserian ganglion, however
Trigeminal Neuralgia
with the advancement of MRI and CT the treatment
(TN - tic douloureaux) is a disorder
target is now the trigeminal root entry zone. The success
of the fifth cranial nerve with clinical
rate has been very high and Gamma Knife SRS is now
features of; sharp stabbing
the leading form of non-medical treatment.
paroxysms of pain, usually on one
Trigeminal Neuralgia (TN – tic douloureaux) is
side of the face with trigger points
a disorder of the fifth cranial nerve with clinical
features of; sharp stabbing paroxysms of
pain, usually on one side of the face with
trigger points, in a distribution limited to
the trigeminal nerve. The sensory division
of the nerve distributes these recurrent painful
attacks through the branches leading from the
face, and is typically felt on one side of the jaw,
cheek, gums or forehead. Although rare, the
pain can be bilateral. Facial pain may result from
compression or irritation of the trigeminal nerve by a
loop of artery or vein, a tumor beside the nerve, or de-myelinizing plaque.
Possible contributing factors include sinus, jaw or teeth infections, trauma, or degeneration of the gasserian ganglion.
TN affects approximately 1 in 10,000 persons and, although not
fatal, it may severely incapacitate the patient’s lifestyle. TN occurs more
commonly in women, particularly the 50 and over age group, but no
one is immune.
Trigeminal Neuralgia may be controlled by a variety of pharmacological
agents or invasive procedures such as; anticonvulsant medications
(including Dilantin, Tegretol, and Trileptal), glycerol rhizotomy,
radiofrequency rhizotomy, balloon compression, microvascular decomContinued
pression, or Gamma Knife SRS.
“Success rates for the treatment
of trigeminal neuralgia
with GammaKnife SRS have
been 80-90 percent”
Continued from cover story
Trigeminal Neuralgia
Aloha!
Physician Highlight
Dr. Leon K.
Liem earned his
medical degree
from Albert
Einstein College
We recently celebrated our 500th patient
treated at the Gamma Knife Center of
the Pacific, however, I remember very
well our first patient who is mentioned
elsewhere in this newsletter. I remember how happy she was that she did not
have to undergo a craniotomy and
could be treated on the gamma knife.
She has remained one of our most
enthusiastic supporters over the years.
of Medicine in
the Bronx, New
York. He completed his internship
in general surgery at the University
of Maryland Medical Systems,
his rotation in the Neurosurgery
Department at the Barrow
Neurological Institute in Phoenix,
Elsewhere in this newsletter is an article
on trigeminal neuralgia and it has been
very gratifying over the years to see
many patients relieved of their severe
facial pain. Many of these patients have
been very elderly and were at too high a
risk to undergo surgery, which is the
other treatment alternative. Fortunately,
age is not a problem for treatment with
the gamma knife.
Arizona, and his residency training
also at University of Maryland. He is
Board Certified by the National
Board of Medical Examiners and the
We at the Gamma Knife Center would
like to thank, once again, all of our
supporting physicians and patients who
have made this center a success.
American Board of Neurological
Surgery. Dr. Liem’s clinical interests
Sincerely,
are in complex spine surgery, Gamma
Knife Radiosurgery, endoscopic
spine & cranial surgery, cerebrovascular surgery and pain neurosurgery.
Maurice W. Nicholson, M.D.
Medical Director
Overall success rates for Gamma Knife SRS have been 80-90 percent, with
only 10 percent having recurrent pain after three years with the option to
repeat Gamma Knife treatment. At the Gamma Knife Center of the Pacific
we have successfully treated over 100 cases of TN and results of a survey
conducted show that 80% of these patients had partial or complete relief
from their pain. When asked in the survey if they would recommend
Gamma Knife surgery to other patients for treatment of Trigeminal
Neuralgia only two respondents said they would not.
The success and exponential growth in the use of the Gamma Knife
for treatment of trigeminal neuralgia has made it the preferred minimally
invasive treatment by physicians and patients here in Hawaii and the Pacific.
Our First Patient
On December 1, 1998 Vera, a lovely
70 year old woman was treated for an
acoustic neuroma which had produced
symptoms of dizziness and dysesthesia into
the right face. She had been very afraid of
having surgery performed because of the
potential complications, including that of a
right facial paralysis. She was very happy that
the gamma knife treatment was available for
her, and post operatively she was very grateful
and happy for having had treatment at our center.
On December 11, 2000 we received a letter in which she made
the following statement; “Thanks again for your wonderful care and
for the gamma knife machine. I hope more people take advantage of
it, it’s a ‘Godsend’.” Vera has since moved to the mainland to take
care of her older sister. She again wrote the Gamma Knife Center
of the Pacific on Septmeber 23, 2002 stating she was doing very well;
“I will always remember the great care I received on that day,
December 1, 1998. You and your staff have a happy holiday season
that will soon be upon us”.