Recently (November 2015), I (Ronald Brisman M.D.) have seen in my office two patients whom I treated many years ago. They both remained free of pain without medicines for many years following minimally invasive treatment for intractable trigeminal neuralgia.
One is now a 79-year-old woman who had intractable trigeminal neuralgia in 1999 and I treated her with Gamma Knife radiosurgery (GKRS). Pain recurred 2 years later and I did a repeat GKRS. She then did very well for 14 years; she had no pain and required no medicines. A few months ago, pain returned and could not be satisfactorily managed with medicines. Because of this I did a third GKRS, which she tolerated well and uneventfully.
The second patient is a 64-year-old woman for whom I did a percutaneous trigeminal radiofrequency electrocoagulation (RFE) 22 years ago. She did very well without recurrent pain and without the need for medicines. She came to see me a few days ago because she started to get very mild non-painful sensations that worried her. At present, we are not planning to do another procedure, but she is reassured to know that if pain returns and cannot be well managed with non-bothersome doses of medicines, she could be helped in a minimally invasive manner.
Although patients vary a great deal in their response to treatment, and all patients do not get such prolonged relief of pain from one procedure, it is still important to emphasize that patients who have medically intractable trigeminal neuralgia can often be managed very well with minimally invasive procedures (Gamma Knife radiosurgery or percutaneous procedure with RFE and/or glycerol.)