Stereotactic Radiosurgery for Treatment of Epilepsy

Quigg, Mark; Barbaro, Nicholas M.

doi:10.1001/archneurol.2007.40

Cited by 50 publications

(39 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With few exceptions, high-dose protocols (Ͼ20 Gy) yielded better short-term seizure remission than lower dose protocols. 8 In the current report, high-dose RS treatments resulted in larger radiologic changes; accordingly, the presence of a "significant" T2 hyperintensity lesion (volume Ͼ200 mL) at the 12-month postoperative mark strongly predicted good seizure and quality of life outcomes.…”

Section: Fluid-attenuated Inversion Recovery Coronal (A-e) T1 Coronamentioning

confidence: 52%

Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy

Chang

Quigg

et al. 2010

Neurology

View full text Add to dashboard Cite

show abstract

Section: Fluid-attenuated Inversion Recovery Coronal (A-e) T1 Coronamentioning

confidence: 52%

Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy

Chang

Quigg

et al. 2010

Neurology

View full text Add to dashboard Cite

show abstract

“…Some nonsurgical techniques have also been published. 46,49 Intraventricular hypothalamic hamartoma disconnection was first reported by Delalande and Fohlen 19 (Fig. 4).…”

Section: Hamartoma Disconnectionmentioning

confidence: 88%

Hemispherotomy and other disconnective techniques

Ribaupierre

Delalande

2008

FOC

View full text Add to dashboard Cite

The surgical treatment of intractable epilepsy has evolved as new technical innovations have been made. Hemispherotomy techniques have been developed to replace hemispherectomy in order to reduce the complication rates while maintaining good seizure control. Disconnective procedures are based on the interruption of the epileptic network rather than the removal of the epileptogenic zone. They can be applied to hemispheric pathologies, leading to hemispherotomy, but they can also be applied to posterior quadrant epilepsies, or hypothalamic hamartomas. In this paper, the authors review the literature, present an overview of the historical background, and discuss the different techniques along with their outcomes and complications.

show abstract

“…3,13,25,30,36) Furthermore, delayed seizure control of GKRS exposes patients to many risks such as injury, drowning, or unexpected death associated with seizure. 22) Immediate cessation of seizure seems to decrease mortality after epilepsy surgery. Evaluation of 215 patients with temporal lobe epilepsy found 3 of 148 (2%) seizure-free patients died after surgery, compared with 8 of 67 (11.9%) non-seizure-free patients.…”

Section: Discussionmentioning

confidence: 99%

“…13,30,36) To date, the seizure outcome in patients with MTLE after GKRS has not been consistent. 22) In the studies with good seizure outcome, non-invasiveness and safety were emphasized as major advantages of GKRS over resective surgery. However, some disadvantages of this treatment, such as delayed response and delayed radiation necrosis (DRN) were identified.…”

Section: Introductionmentioning

confidence: 99%

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

Kawamura

Onishi

Kohda

et al. 2012

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Gamma knife radiosurgery (GKRS) for mesial temporal lobe epilepsy (MTLE) has been proposed as an alternative to surgical resection. We report serious adverse effects of the treatment after follow-up periods over 9 years in 11 patients treated with GKRS between 1997 and 2000. The target volume of the entorhinoamygdalohippocampectomy area was 4.8-17.1 ml. Marginal dose of 20-25 Gy to the 50% isodose was delivered. One patient was drowned after suffering seizure 7 months after GKRS. Two patients did not show any reduction in seizure frequency over 9 and 18 months. Both patients requested open surgery and became seizure-free postoperatively. Four of the other eight patients were classified as Engel's class I within 4 years after GKRS. One of the four patients experienced symptomatic radiation-induced cerebral edema transiently, one developed radiation necrosis and required surgery 5 years after GKRS, and one developed cognitive impairment with hemiparesis 10 years after GKRS. Magnetic resonance (MR) imaging showed a large cyst in the irradiated temporal lobe. This patient recovered fully after the cyst excision. Only one patient became seizure-free and antiepileptic drug-free without symptomatic radiation-induced complications. However, MR imaging revealed abnormal enhancement, cyst formation, and diffuse white matter change in the irradiated temporal lobe 9 years after GKRS. GKRS for MTLE causes adverse effects of delayed seizure remission and symptomatic radiationinduced complications. Therefore, GKRS cannot be considered as an ideal alternative to surgery for MTLE. Long-term follow-up studies including MR imaging with contrast medium are required for the patients even after successful control of seizures.

show abstract

Stereotactic Radiosurgery for Treatment of Epilepsy

Cited by 50 publications

References 38 publications

Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy

Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy

Hemispherotomy and other disconnective techniques

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

Contact Info

Product

Resources

About