South Florida Hospital News
Sunday July 21, 2019

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August 2013 - Volume 10 - Issue 2




Aizik Wolf, M.D., Is a Leader in Performing Gamma Knife Procedure for Relief of Trigeminal Neuralgia

On February 14, 2013, neurosurgeon Aizik L. Wolf, M.D., Medical Director of the Miami Neuroscience Center at Larkin Community Hospital, gave Ina Knight the best Valentine of her life. He made her whole again, after she had suffered for years with the excruciating pain syndrome known as trigeminal neuralgia. He did this by successfully performing Gamma Knife radiosurgery on the 66-year old Margate resident, who had been misdiagnosed by doctors who assumed that the etiology of her lower right jaw pain was dental – a common mistake. She had undergone multiple root canals and tooth extractions, to no avail. The pain persisted, triggered by even subtle stimuli, to such a degree that she was eventually unable to chew, smile, laugh and talk without pain. Her life shut down: she stopped working as a medical secretary; she could no longer go out to restaurants or enjoy dinners with her children and grandchildren. Ina was living in misery and isolation, eating pureed foods, her life dominated by pain.
In October 2012, the pain was severe enough to require hospital admission. At that point, she was referred to Dr. Wolf, who told her that treatment of her trigeminal neuralgia with the Gamma Knife would offer her the relief she so desperately sought. “I talked with one of his former patients, and she told me that she had experienced tremendous relief after having the Gamma Knife procedure. She convinced me. Dr. Wolf explained that it was the most advanced and effective treatment available. So I agreed to have it done and I’m so glad I did.”
Dr. Wolf, a graduate of Yale University Medical School, and his colleagues are one of the most experienced Gamma Knife teams in the U. S. Since 1991, he has done 7,000 Gamma Knife procedures, including the treatment of over 1,000 trigeminal neuralgia patients who come from all over the globe seeking his expert care. Often, they are desperate people, hoping for relief from what Wolf describes as “the most painful sensation one can have in the face.” He explains: “Trigeminal neuralgia has a classic presentation: it feels like a hot poker or an electric shock that comes out of nowhere, searing along the trigeminal nerve. The pain is intermittent and of short duration, but always returns. It can be triggered by brushing your teeth, eating – even by the wind on your face. The pain is incredible. It’s more common in women and in people over 50, and those with multiple sclerosis have a higher risk. It can also occur as a consequence of shingles, if the shingles affects the face. It’s a form of post-herpetic neuralgia and can be difficult to treat. It’s a good motivation for getting your shingles shot!”
Trigeminal neuralgia is believed to be the result of physical changes in the brain as we age, in combination with hardening of the brain arteries. “As we age, our brains sag and our arteries harden, and they can compress the nerve. Eventually, there may be damage to the nerve,” Wolf explains. Not everyone with trigeminal neuralgia will require surgery; there are medical treatments that can be effective. Traditional approaches to pain management, however, are ineffective – narcotics don’t seem to work on neuralgia pain. Many people will have a good response to Tegretol, an anti-seizure medication, but some cannot tolerate the side effects, including loss of balance and confusion. Wolf estimates that 15-20% of those with the condition will need surgery.
The Gamma Knife is an advanced technology that utilizes computers and cobalt to send radiation like a laser to a very specific target. The procedure is non-invasive, precise, involves no incision and can be done on an outpatient basis. It can take a few weeks for the radiation to have the desired effect, but the long-term outcome is excellent: it offers 85-90% effective pain relief.
The first Gamma Knife procedure in the U.S. took place at the University of Pittsburgh Medical Center, in 1987. Wolf was the first neurosurgeon to bring it to Florida, and the first in the country to do it as an outpatient procedure – which is the standard now. “For effective treatment of trigeminal neuralgia,” he says, “three things are essential: the right diagnosis, right medication and right referral. Do your homework - it’s critically important to find a neurosurgeon who has ‘experienced hands’ and has done hundreds of these.”
Wolf travels the world lecturing, teaching and sharing his expertise. He says that performing Gamma Knife procedures to relieve the pain of trigeminal neuralgia is deeply satisfying. Like Ina Knight, his patients are filled with gratitude. “I feel that Dr. Wolf has given me back my life,” Knight says.” I can eat, smile and kiss my grandchildren again. Dr. Wolf is a blessing and his staff is the best I have ever encountered in a hospital. After years of living with excruciating pain, I’m a new person, thanks to Dr. Wolf.”
To contact Dr. Wolf and to learn more about trigeminal neuralgia and the Gamma Knife technology, visit or call (786) 871-6800.
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