A new study shows that radiosurgery reduces depression and helps improve the overall quality of life for patients with trigeminal neuralgia (TN) — a very painful nerve disorder that causes an electrical shock feeling in the face, usually in older people.
The findings, published in the International Journal of Radiation Oncology*Biology*Physics, assert that doctors should consider radiosurgery — typically a second line treatment to be used following medication — as an earlier option as it could make a huge difference in patients’ lives.
On a scale of 1-10, patients with TN often describe the pain as 15 — off the scale. TN attacks are often random but can be triggered by everyday things such as chewing or even the wind blowing.
TN is commonly treated with anti-epileptic medications. While these drugs can reduce the pain, they often makes patients drowsy, tired and “drunk-feeling.” This has a large effect on their quality of life and frequently leads to depression, as it prevents them from driving, working or even just leaving the house.
“We knew radiosurgery results in pain relief, but we didn’t know if the patients actually felt better,” said study author Dr. Samuel Chao at the Cleveland Clinic. “I think people go and see their neurologist and get the pain under control with medication, but they don’t realize how lousy this can make them feel.”
“Using radiosurgery earlier on allows patients to get off the medications, improving their quality of life by allowing them to return to activities they used to do.”
Radiosurgery is a method that physically treats the nerve with radiation. While using a treatment called stereotactic radiosurgery, doctors can focus 192 beams of radiation on a single point. Because it is non-invasive, it doesn’t require the healing time of traditional surgery. In fact, treatment takes less than an hour and requires no anesthetic.
However, radiosurgery is often overlooked or delayed as a treatment because there is a lack of capability and experience with the method. Studies have shown that radiosurgery reduces pain for 80 percent of patients, but the broader impact on their lives remained unknown.
For the new study, the researchers gathered data from 50 patients they treated with radiosurgery using two questionnaires: EuroQOL 5-Dimension and Patient Health Questionnaire 9.
Patients reported their levels of pain and facial numbness, their health and their ability to care for themselves. The researchers analyzed patients’ answers before treatment and at each follow-up appointment, and discovered that patients reported an improved quality of life and lower rates of depression after radiosurgery.
“Pain and the medication to stop the pain make it difficult for people with TN to go outside and live life,” said Chao.
“With radiosurgery, we can reduce pain, improve quality of life and decrease depression — people can go out and enjoy life without worrying they will have a random attack. Giving options empowers the patient to be more aware of themselves and manage their own condition.”