A Multicenter, Prospective Pilot Study of Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy: Seizure Response, Adverse Events, and Verbal Memory

2010 ◽  
Vol 2010 ◽  
pp. 223-224
Author(s):  
P.A. House
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Temporal Lobe Epilepsy ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Prospective Pilot Study ◽  
Mesial Temporal Lobe

FAILURE OF GAMMA KNIFE RADIOSURGERY FOR MESIAL TEMPORAL LOBE EPILEPSY: REPORT OF FIVE CASES

Neurosurgery ◽  
2004 ◽  
Vol 54 (6) ◽  
pp. 1395-1404 ◽  
Author(s):  
Teeradej Srikijvilaikul ◽  
Imad Najm ◽  
Nancy Foldvary-Schaefer ◽  
Tara Lineweaver ◽  
John H. Suh ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe

scholarly journals Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
John D. Rolston ◽  
Mark Quigg ◽  
Nicholas M. Barbaro
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Surgical Resection ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Open Surgery ◽  
Controlled Trial ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Noninvasive Treatment ◽  
Mesial Temporal Lobe

Many patients with mesial temporal lobe epilepsy continue to have seizures despite medical therapy. For these patients, one recourse is surgical resection of the mesial temporal lobe, with its attendant risks. Noninvasive treatment with Gamma Knife radiosurgery is under active investigation as a possible alternative to open surgery. Accumulated evidence from multiple studies shows radiosurgery to be comparable in outcomes to surgical resection. A definitive randomized, controlled trial, the Radiosurgery or Open Surgery for Epilepsy (ROSE) trial, is currently underway, and further investigation of this promising treatment is crucial in our advancement of alternative therapies to treat refractory epilepsy.

scholarly journals Serious Adverse Effects of Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy

2012 ◽  
Vol 52 (12) ◽  
pp. 892-898 ◽  
Author(s):  
Tetsuro KAWAMURA ◽  
Hiroaki ONISHI ◽  
Yukihiko KOHDA ◽  
Genjiro HIROSE
Keyword(s):  
Adverse Effects ◽  
Temporal Lobe Epilepsy ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe

Gamma knife surgery for mesial temporal lobe epilepsy

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 141-146 ◽  
Author(s):  
Jean Régis ◽  
Fabrice Bartolomei ◽  
M. Rey ◽  
Motohiro Hayashi ◽  
Patrick Chauvel ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Morphological Changes ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Content Type ◽  
Mesial Temporal Lobe ◽  
Fine Print

Object. Gamma knife radiosurgery (GKS) allows precise and complete destruction of chosen target structures containing healthy and/or pathological cells, without causing significant radiation damage to adjacent tissues. Almost all the well-documented cases of radiosurgery for epilepsy are for epilepsies associated with space-occupying lesions. These results prompted the authors to investigate the use of radiosurgery as a new way of treating epilepsy not associated with space-occupying lesions. Methods. To evaluate this new method, 25 patients who presented with drug-resistant mesial temporal lobe epilepsy (MTLE) were selected. A follow up of more than 24 months is now available for 16 patients. The preoperative evaluation was performed as it usually is in patients selected for microsurgery for MTLE. In lieu of microsurgery, the treatment of amygdalohippocampal structures was performed using GKS. Thirteen (81%) of these 16 patients are seizure free, and two are improved. The median latent interval from GKS to seizure cessation was 10.5 months (range 6–21 months). Two patients were immediately seizure free. The median latency in aura cessation was 15.5 months (range 9–22 months). Morphological changes on magnetic resonance imaging were visible at 11 months (median) after GKS (range 7–22 months). During the onset period of these radiological changes, three patients experienced headache associated, in two cases, with nausea and vomiting. In these three patients the signs resolved immediately after prescription of low doses of steroids. No cases of permanent neurological deficit (except three cases of nonsymptomatic visual field deficit), or morbidity, or mortality were observed. Conclusions. This initial experience indicates that there is short- to middle-term efficiency and safety when using GKS to treat MTLE. Further long-term follow up is required. It seems that the introduction of GKS into epilepsy treatment can reduce the invasiveness and morbidity.

Delayed Compressive Angiomatous Degeneration in a Case of Mesial Temporal Lobe Epilepsy Treated by Gamma Knife Radiosurgery

Neurosurgery ◽  
2010 ◽  
Vol 67 (1) ◽  
pp. E218-E220 ◽  
Author(s):  
Patrice Finet ◽  
Herbert Rooijakkers ◽  
Catherine Godfraind ◽  
Christian Raftopoulos
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Gamma Knife Radiosurgery ◽  
Major Complication ◽  
Surgical Excision ◽  
Corticosteroid Treatment ◽  
Mesial Temporal Lobe Epilepsy ◽  
Brain Parenchyma ◽  
Mesial Temporal Lobe

Abstract OBJECTIVE Mesial temporal lobe epilepsy (MTLE) is one of the most common causes of intractable partial epilepsy. The conventional treatment of patients with MTLE is surgical excision. Currently, gamma knife (GK) radiosurgery is being explored as an alternative treatment. We report the first delayed major complication related to this treatment. CLINICAL PRESENTATION A 54-year-old woman with a medical history of a post-viral encephalitis in childhood was treated in April 2001 by GK radiosurgery for a medically refractory MTLE. Her right temporomesial area received a dose of 20 Gy at the 50% marginal isodose line. Unfortunately, the patient continued to experience seizures, although they were of shorter duration and occurred less frequently. She was seen in our department on November 8, 2007, for an intracranial hypertensive syndrome. The imaging work-up showed an expansive hemorrhagic lesion in the right mesiotemporal area. Despite corticosteroid treatment, the patient still complained about headaches on November 13, and surgery was scheduled for November 22. However, the patient returned to the emergency department on November 16 with a temporal herniation syndrome requiring an urgent surgical procedure. INTERVENTION The expansive lesion was completely removed. Histologic examination revealed lesions of the gray and white matter consisting of severe gliosis, hemorrhagic foci, hyalinized vessels, and neovascularization, giving the brain parenchyma an angiomatous aspect. CONCLUSION Although reports on GK radiosurgical treatment of MTLE are encouraging, this case stresses the risk of developing 6 years later an angiomatous degeneration of the targeted brain with life-threatening intracranial hypertension.

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