Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report

선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고

  • Yun Hyong-Geun (Department of Radiation Oncology, Dongguk University International Hospital)
  • 윤형근 (동국대학교 일산불교병원 방사선종양학과)
  • Published : 2006.06.01
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Abstract

Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

삼차신경통은 삼차신경의 안면피부 분포를 따라서 일시에 생기는 전기적 쇼크와도 같은 강한 통증이다. 약물치료로서 통증을 제어할 수 없게 되면 여러 가지 시술로 통증제어를 시도하게 된다. 정위적 방사선수술은 비침습적인 방법으로 부작용이 거의 없이 유의한 통증완화를 이루어 내는 것으로 밝혀져 있다. 그동안 삼차신경통의 방사선수술에 감마나이프가 주로 사용되었지만 최근에 선형가속기도 사용되기 시작하였다. 저자는 삼차신경통 환자 1명에 선형가속기를 이용하여 방사선수술을 시행하였다. 뇌간으로부터 나온 삼차신경 기시부에 5 mm collimator를 이용하여 85 Gy를 조사하였다. 환자는 치료 후 20일 경부터 통증이 거의 소실되었으며 6개월이 지난 현재까지 약물복용 없이도 통증이 없는 상태이다. 환자는 안면 무감각증 등 부작용이 없었다. 선형가속기를 이용한 정위적 방사선수술로 삼차신경통을 치유한 예는 아직 국내에서 보고된 적이 없기에 문헌고찰과 함께 보고한다.

Keywords

References

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