Trigeminal neuralgia is a chronic pain condition characterized by recurrent episodes of intense facial pain. This disorder affects the trigeminal nerve which is responsible for sensory function and neural signaling in regions of the head and face. While individual attacks often last only a few seconds, episodes can persist for up to two minutes and may recur multiple times throughout the day.
It is a severe condition requiring long-term medical treatment. Up to 10% of patients will suffer major adverse drug-related effects and some sort of surgery or stereotactic radiosurgery may be offered, and based on scientific research, CyberKnife should be among those treatment options, including for patients with Multiple Sclerosis who develop TN.
Professor Alexander Muacevic, Medical Director of the European CyberKnife Centre in Munich, Germany says,“Trigeminal neuralgia is one of the most excruciating and disabling neurological conditions, marked by sudden, electric shock-like facial pain. For patients with MS, the risk is dramatically higher – nearly 20 times that of the general population. Treatment with the CyberKnife System takes only about 30 minutes: A powerful avenue in the interdisciplinary care of MS patients with trigeminal neuralgia.”
To date the largest single-center experience with radiosurgery on the CyberKnife System for the treatment of TN reported the clinical outcomes of 387 treatments on patients.
The Results: All patients achieved good pain control. Only 12.8% of patients required a second treatment.
Conclusion: Stereotactic radiosurgery is a reliable first-line treatment for TN. This study using frameless radiosurgery with the CyberKnife System found the method effective, with low rates of sensory complications and 76% achieving lasting pain relief.
Another Study Reveals the Outcome of CyberKnife Radiosurgery for Trigeminal Neuralgia in Patients with Multiple Sclerosis
Their long-term pain relief rates reached 92.7%, 62.6%, 49.5%, and 32.5%. The most common complication, facial hypesthesia, occurred in 15.7% of cases, but in most cases it was temporary and only mild. Other side effects, such as temporary chewing weakness, were rare and usually temporary.
Conclusion: This was the first known study to assess the CyberKnife System for the treatment of TN in MS patients. The results demonstrate the efficacy of the CyberKnife System.
Other treatments such as microvascular decompression, have not conclusively shown effectiveness for these patients, therefore radiosurgery should be considered as a good option to provide pain relief.
It was found that patients with MS and a neurovascular conflict appear to benefit from this approach the most. This study help influence clinical decision making.
Summary: In patients with trigeminal neuralgia, CyberKnife System radiosurgery consistently demonstrated high initial pain relief, including refractory cases and those with MS.
Initial pain relief ranged from 85.7% – 92% within 14 days – 6 months. Long-term durability varied: recurrence can occur in patients, though re-treatment remained effective.
Higher doses and presence of vascular compression were associated with better outcomes. Complications such as facial hypesthesia and numbness are generally mild and temporary, with severe adverse effects like anesthesia dolorosa rarely observed.
These findings highlight the importance of treatment planning and precision imaging, helping to maximize patient comfort and long-term quality of life. Overall, the CyberKnife System provided effective, non-invasive pain control for trigeminal neuralgia.
To find out if CyberKnife can help you relieve facial pain caused by Trigeminal Neuralgia call the most experienced team at the CyberKnife Center of Miami at 305-279-2900. Chances are you’ll be happy you did.
Read more clinical evidence on the CyberKnife System
References
- NIH (2025), ‘Trigeminal Neuralgia.’ https://www.ninds.nih.gov/health-information/disorders/trigeminal-neuralgia
- Romanelli P, Conti A, Redaelli I, et al. (October 28, 2019) CyberKnife Radiosurgery for Trigeminal Neuralgia. Cureus 11(10): e6014. DOI 10.7759/cureus.6014
- Romanelli P, Conti A, Bianchi L, Bergantin A, Martinotti A, Beltramo G. Image-Guided Robotic Radiosurgery for Trigeminal Neuralgia. Neurosurgery. 2018 Nov 1;83(5):1023-1030. doi: 10.1093/neuros/nyx571. PMID: 29294132; PMCID: PMC6195178.
- Guillemette A, Roberge D, Ménard C, Bahary JP, Bou Assi E, Nguyen DK, Obaid S, Fournier-Gosselin MP. Outcomes of CyberKnife Radiosurgery for Trigeminal Neuralgia in Patients with Multiple Sclerosis. Can J Neurol Sci. 2025 Mar 3:1-7. doi: 10.1017/cjn.2025.37. Epub ahead of print. PMID: 40026079.
- Alan Monroe et al ‘3493 – A Non-Invasive Stereotactic Mimicking Radiosurgery with a Frameless Robotic Radiosurgery: A Comparison of Dose Prescription Methodologies for Treatment of Trigeminal Neuralgia.
https://www.accuray.com/blog/exploring-the-impact-of-advanced-radiosurgery-on-trigeminal-neuralgia/