A University of Alberta clinical trial could offer new hope for people worldwide living with one of the most painful conditions there is.
Trigeminal neuralgia - once dubbed the "suicide disease" - leads to excruciating, stabbing facial pain set off by daily activities like eating, brushing the teeth or yawning. About 700 new cases are diagnosed in Alberta each year.
Patients are usually treated with nerve pain medications but, as repurposed anti-seizure medications, these have side-effects such as blurry vision, imbalance and allergies. And they eventually stop working for about half of those who take them.
Until now, non-invasive surgery using Gamma Knife radiation has been offered as a last resort after medications stop being effective.
"We treat trigeminal neuralgia by giving a pretty high dose of radiation to the trigeminal nerve on the affected side, but the longer you wait before you offer Gamma Knife, the less likely it is to lead to long-term remission of the disease," explains Tejas Sankar, associate professor of surgery and neurosurgery research director in the Faculty of Medicine & Dentistry.
Now Sankar and his team are recruiting 80 patients from across the province to receive immediate Gamma Knife neurosurgery at the Scott and Brown Families Gamma Knife Centre at the University of Alberta Hospital, the only facility of its kind in the province.
Half of the patients will receive the usual medications; the other half will receive "ultra-early" Gamma Knife surgery. Patients in the control arm will have the option of receiving Gamma Knife treatment later if they choose.
Sankar explains that his team's research using functional MRI indicates that living with trigeminal neuralgia actually changes the way the brain works. The trial aims to stop those changes before they become permanent.
"What we found was - and this shouldn't come as too much of a surprise - the longer you have this facial pain condition, the more lasting changes occur in the brain both structurally and functionally," Sankar says.
