Stereotactic radiosurgery (SRS) offers a reasonable benefit to risk profile for patients with multiple sclerosis (MS)-related trigeminal neuralgia who have exhausted medical management, according to a recent study. Furthermore, more favorable initial response to SRS may predict a long-lasting pain control. Researchers conducted a retrospective cohort study consisting of 263 patients contributed by 9 member tertiary referral gamma knife centers (2 in Canada and 7 in USA) of the International Gamma Knife Research Consortium (IGKRF). They found:

• The median latency period of pain response (PR) after SRS was 1 month.
• Reasonable pain control (Barrow Neurological Institute [BNI] Pain Scores I-IIIb) was achieved in 232 patients (88.2%).
• The median maintenance period from SRS was 14.1 months (range, 10 days to 10 years).
• The actuarial reasonable pain control maintenance rates at 1 year, 2 years, and 4 years were 54%, 35%, and 24%, respectively.
• Among 210 patients with known status of post-SRS complications, the new-onset of facial numbness (BNI-I or II) after SRS occurred in 21 patients (10%).