The first treatment option for secondary trigeminal neuralgia: open surgery versus stereotactic radiosurgery

Abstract

Trigeminal neuralgia (TN) is a condition involving oro-facial pain that causes patients to suffer and significantly impacts their quality of life. TN can generally be classified into three categories: classical, secondary, and idiopathic. Among these, secondary TN, which accounts for approximately 15% of cases, is attributed to identifiable neurologic diseases such as tumors and multiple sclerosis. Although the clinical features of classical and secondary TN are similar, secondary TN should be treated individually based on its underlying pathology. This paper presents a case of secondary TN induced by meningioma. The patient underwent Gamma Knife radiosurgery twice but showed no improvement in symptoms, ultimately leading to surgical removal of the tumor. The diagnosis-to-surgery time was 2 years. This case report discusses the first-line treatment options for secondary TN, with a focus on symptom relief.