r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2025-30-4-51-56r-n-j-730Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSСтереотаксическая радиохирургия при вторичной тригеминальной невралгии у пациентов с рассеянным склерозомStereotactic radiosurgery for secondary trigeminal neuralgia in patients with multiple sclerosishttps://orcid.org/0000-0003-0521-4836РожноваЕ. Н.RozhnovaE. N.

Москва, Россия

Moscow, Russia

doc.rozhnova.E@yandex.ruhttps://orcid.org/0000-0001-8099-9544ЕвдокимоваО. Л.EvdokimovaO. L.

Москва, Россия

Moscow, Russia

https://orcid.org/0000-0002-4534-8719РакВ. А.RakV. A.

Москва, Россия

Moscow, Russia

https://orcid.org/0000-0001-5026-0060СинкинМ. В.SinkinM. V.

Москва, Россия

Moscow, Russia

https://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

Москва, Россия

Moscow, Russia

ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского» ДЗ г. МосквыРоссияN.V. Sklifosovsky Research Institute of Emergency MedicineRussian FederationГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского» ДЗ г. Москвы; ФГАОУ ВО «РНИМУ им. Н.И. Пирогова (Пироговский Университет)»РоссияN.V. Sklifosovsky Research Institute of Emergency Medicine; Pirogov Russian National Research Medical University (Pirogov University)Russian Federation2025041020253045156Copyright © Рожнова Е.Н., Евдокимова О.Л., Рак В.А., Синкин М.В., Гринь А.А., 20252025Рожнова Е.Н., Евдокимова О.Л., Рак В.А., Синкин М.В., Гринь А.А.Rozhnova E.N., Evdokimova O.L., Rak V.A., Sinkin M.V., Grin A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/730

Цель работы: оценка эффектов радиохирургического лечения пациентов с вторичной фармакорезистентной тригеминальной невралгией (ТН) у больных рассеянным склерозом (РС).Материал и методы. Представлены результаты наблюдения 14 пациентов с вторичной ТН на фоне РС. С целью снижения интенсивности болевого синдрома проведена стереотаксическая радиохирургия (СРХ) на аппарате «Гамма-нож». Мишенью облучения назначена средняя треть цистернальной порции тройничного нерва с максимальной дозой 80–90 Гр. Интенсивность боли до и после СРХ, а также при рецидивах оценена по визуально-аналоговой шкале и шкале боли Неврологического института Barrow (Barrow Neurological Institute Pain Scale. Осложнения СРХ классифицированы по шкале лицевой гипестезии Неврологического института Barrow (Barrow Neurological Institute facial hypoesthesia scale. Срок наблюдения за пациентами после СРХ составил 24,4 [17,5; 41] месяца.Результаты. Уменьшение боли после СРХ наступило у 85,7% пациентов. Сроки развития улучшения — 1–2 месяца после СРХ. Осложнения в виде гипестезии и/или парестезии отмечены у 28,6%. Рецидивы заболевания возникли у 58,3% пациентов, у 57% из них боль удалось купировать лекарственными препаратами.Заключение. Радиохирургическое лечение пациентов с ТН, обусловленной РС, обладает высокой эффективностью и хорошей переносимостью. Лечение на «Гамма-ноже» следует рассматривать в качестве приоритетного среди хирургических подходов.

Objective: to evaluate the eff ects of stereotactic radiosurgery (SRS) in patients with drug-resistant trigeminal neuralgia (TN) secondary to multiple sclerosis (MS).Material and methods. The article presents the results of observation of 14 patients with TN secondary to MS. In order to reduce the intensity of pain syndrome, stereotactic radiosurgery was performed using the Gamma Knife. The irradiation target was the middle third of the cisternal portion of the trigeminal nerve with a maximum dose of 80–90 Gy. Pain intensity before and after SRS, as well as during relapses, was assessed using the visual analogue scale and the Barrow Neurological Institute Pain Scale (BNI PS). Complications of SRS are classifi ed according to the Barrow Neurological Institute facial hypoesthesia scale (BNI fhs). The observation period for patients after SRS was Me = 24.4 [17.5; 41] months.Results. Pain relief after SRS occurred in 85.7% of patients. The improvement developed within 1–2 months after SRS. Complications in the form of hypoesthesia and/or paresthesia were noted in 28.6%. Relapses of the disease were diagnosed in 58.3% of patients after SRS, and in 57% of them the pain was relieved by medications.Conclusion. Stereotactic radiosurgery of patients with MS-related TN is highly eff ective and well tolerated. The use of the Gamma Knife should be considered a priority given the variety of surgical approaches.

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The authors declare that there are no conflicts of interest present.