Progress has been made in the recent years both for the pathogenesis and surgical treatment due to implementation of neuroradiological techniques. Surgery has also taken advantage from the introduction of the endoscope and neuronavigation in the operating room. New drugs, such as BTX-A, may be offered to patients before surgery or to patients unwilling to undergo surgery. Better definition of GKRS targets would improve the results of this technique. Neurostimulation might represent an opportunity in patients refractory to other surgical treatments, but further studies are needed due to the few cases treated.