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February 21, 2012 > High Tech Gamma Knife Gives Patients Virtually Pain Free Treatment Alternative

High Tech Gamma Knife Gives Patients Virtually Pain Free Treatment Alternative

Washington Hospital's powerful and precise Leksell Gamma Knife Perfexion is well known for effectively treating many types of cancerous and non-cancerous brain tumors. But, did you know doctors use this advanced technology as a virtually painless way of treating a range of other disorders?

For example, the Gamma Knife can safely and effectively treat trigeminal neuralgia, a facial pain syndrome. This condition causes excruciating pain, which can be brought on by the slightest touch or movement of the face, such as brushing your teeth or putting on make-up. The pain can extend into the ear, forehead, chin or cheek. Considered one of the most painful conditions of the human body, trigeminal neuralgia can make the facial movements from chewing so painful that a patient may even stop eating.

"People compare the pain from trigeminal neuralgia to an electric shock traveling through one side of the face," said noted neurosurgeon Sandeep Kunwar, M.D., co-medical director of the Gamma Knife Program at Washington Hospital. "It is believed to happen when a blood vessel brushes against a sensory nerve to the face."

Trigeminal neuralgia is most common among people in their sixties and seventies and occurs more often in women. Each year, about 15 out of every 100,000 people develop the condition.

Medication is the most common treatment. Because the pain of trigeminal neuralgia is associated with the body's central nervous system, narcotics are not effective. Anti-seizure medications can be helpful. However, over time, a significant portion of patients will need increased amounts of the medication or it may stop working altogether. Even when the medication is effective, some people experience side effects, such as feeling very tired, sleepy or groggy.

Another treatment option is surgery in which the surgeon makes an incision behind the patient's ear, locates the problem area and inserts a small Teflon patty to keep the artery away from the nerve. However, open surgery under a general anesthetic may not be the best choice for an older patient.

"With Gamma Knife radiosurgery, the results are quite good. Without the need for general anesthesia or an incision, we can target the nerve and usually shut it down so it no longer causes the pain," explained Dr. Kunwar. "This safe, effective procedure has proven to be successful in tens of thousands of patients around the world."

After the Gamma Knife treatment takes effect, approximately 85 percent of patients will become pain free, with 50 percent able to stop their pain medication. Another 35 percent will still require a very low dose of medication.

Gamma Knife treatment for trigeminal neuralgia is done on an outpatient basis and typically takes about two to three hours. Patients go home the same afternoon and are able to resume their normal activities that evening. With this safe procedure, there is no risk of blood loss, infection or potential problems associated with general anesthesia.

One downside is that the procedure does not stop the pain immediately, as with traditional open surgery. After Gamma Knife radiosurgery, it takes about four to six weeks for patients to feel the early effects of the treatment. The full effect occurs after about three months. There is also a chance that the patient may experience numbness in the area of the face where the nerve is located.

"This occurs in about 7 percent of cases," stated Dr. Kunwar. "But, anyone who has experienced trigeminal neuralgia would much prefer having the numbness instead of the sharp, shooting pain."

The Gamma Knife Perfexion at Washington Hospital uses highly focused doses of radiation to target tissue quickly and accurately while leaving nearby healthy tissue unharmed. The radiation is precisely mapped and delivered to the target tissue by one of the most experienced, highly respected medical teams in the world.

"We believe the Gamma Knife Perfexion continues to be the gold standard for many types of radiosurgery, including treatment for trigeminal neuralgia," said radiation oncologist David Larson, M.D., Ph.D., co-medical director of Washington Hospital's Gamma Knife Program.

The Gamma Knife Program is part of the Taylor McAdam Bell Neuroscience Institute at Washington Hospital. At the Institute, world-class physicians, physicists, technologists, nurses and other health care professionals use powerful, leading-edge technologies to treat patients suffering from a wide range of neurological diseases and disorders.

Learn More

To learn more about the Gamma Knife Program at Washington Hospital, go online to To learn more about the Taylor McAdam Bell Neuroscience Institute, go to

Photo Caption: David Larson, M.D., Ph.D., (left) and Sandeep Kunwar, M.D. are the co-medical directors of the Gamma Knife Program at Washington Hospital. Together they have accumulated more than 30 years of experience using advanced technologies like the Gamma Knife to treat many brain tumors non-invasively with excellent results. To learn more about the Gamma Knife Program at Washington Hospital, visit:

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