Nelson's syndrome treatment [Neurosurgery Wiki]

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====== Nelson's syndrome treatment ======

In addition to the treatment of Nelson's syndrome with neurosurgery with/without adjuvant radiotherapy, selective somatostatin analogs and dopamine agonists, as well as other novel agents, have been used with increasing frequency in treating cases of Nelson's syndrome with limited benefit. The risk-benefit profile of each of these therapies is still not completely understood.

Consensus guidelines on the evaluation and management of Nelson's syndrome are lacking
((Palermo NE, Ananthakrishnan S. Re-examining Nelson's syndrome. Curr Opin Endocrinol Diabetes Obes. 2015 Aug;22(4):313-8. doi: 10.1097/MED.0000000000000175. PMID: 26087343.)).

Prophylactic radiotherapy at the time of bilateral adrenalectomy can prevent Nelson's syndrome (protective effect). The most promising pharmacological agents are temozolomide, octreotide, and pasireotide, but these agents are often administered after transsphenoidal surgery. In murine models, rosiglitazone has shown some efficacy, but these results have not yet been found in human studies
((Patel J, Eloy JA, Liu JK. Nelson's syndrome: a review of the clinical manifestations, pathophysiology, and treatment strategies. Neurosurg Focus. 2015 Feb;38(2):E14. doi: 10.3171/2014.10.FOCUS14681. PMID: 25639316.)).

===== Nelson's syndrome treatment with Gamma knife radiosurgery =====

[[Nelson's syndrome treatment with Gamma knife radiosurgery]].