By: Diana Barnes-Brown for Medtech1
New research has shown that, contrary to previous findings, that radiosurgery, also known as “gamma knife treatment,” is not effective at combating cluster headaches. Not only that, the treatments may cause nerve damage in the face.
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Cluster headaches are severe headaches that begin suddenly and usually go away in under an hour. The headaches, as the name suggests, occur in “clusters,” often every day at around the same time, for four to eight weeks in a stretch. The pain can be so intense, however, that sufferers’ lives are often greatly disrupted during “cluster periods,” at times making it hard for those with the condition to lead normal lives, for fear they will be interrupted in the middle of important events or responsibilities by the onset of another “cluster period.” It is not known what causes the headaches, but they are more commonly diagnosed in men than in women, and they do not seem to have any genetic components.
Radiosurgery is so named because it uses radiation to cut tissue. In the case of cluster headaches, radiosurgery targeted a nerve in the face called the trigeminal nerve, because doctors believed this nerve was to blame for the headaches.
A study conducted in 1998 examined the results of trigeminal nerve radiosurgery, and reported favorable results. But until recently, other researchers have not tested these results.
To address the lack, Dr. A. Donnet and colleagues from the Hopital la Timone in Marseille conducted a study of their own. “Since this initial report no other attempts have been made to evaluate trigeminal nerve radiosurgery in chronic cluster headache and no long-term follow-up study has been published,” note the team in the February 2005 issue of the Journal of Neurology, Neurosurgery, and Psychiatry.
The researchers tested the effects of radiosurgery on 10 patients who had suffered from severe cluster headaches for an average of nine years, and were not helped by drug therapy. Three patients reported immediate or almost immediate relief from the headaches and did not suffer further attacks, while three more experienced a drastic improvement in their condition and had few or no attacks in a period of six months.
Of the remaining four, the results were not impressive. Only slight changes in the first couple of weeks after the treatment were noticed by two, and two others reported no change whatsoever in their conditions.
No immediate complications were seen in any of the patients, regardless of the effectiveness of the treatment, but three of the patients later developed sensation changes or problems in their faces.
“Our study does not support… positive results,” noted the researchers. Even though some patients experienced improvements, these were by no means inevitable, and Donnet and his colleagues concluded that possibility of facial nerve damage, when coupled with the limited effectiveness of the procedure, indicated that the risks outweighed the benefits.