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Gamma knife surgery in mesial temporal lobe epilepsy: a prospective multicenter study
Jean Régis1, Marc Rey, Fabrice Bartolomei
1Stereotactic and Functional Neurosurgery Department, Timone Hospital, Marseille (APM), France. j.regis@ap-hm.fr
Epilepsia
|April 23, 2004
Summary
Gamma knife surgery (GKS) effectively treated drug-resistant mesial temporal lobe epilepsy (MTLE), with 65% seizure-free at two years. While safe, GKS showed a delayed seizure cessation compared to traditional surgery.
Area of Science:
- Neurosurgery
- Epileptology
- Radiosurgery
Background:
- Mesial temporal lobe epilepsy (MTLE) is a common cause of drug-resistant epilepsy.
- Traditional treatments like temporal lobectomy carry risks of neurological deficits.
- Gamma Knife Surgery (GKS) offers a less invasive alternative.
Purpose of the Study:
- To prospectively evaluate the efficacy and safety of GKS for drug-resistant MTLE.
- To document outcomes in terms of seizure control and quality of life.
Main Methods:
- Twenty-one patients with MTLE underwent radiosurgery using the Leksell Gamma Knife.
- Targeted irradiation of the hippocampus and amygdala was performed.
- Patients were followed for a minimum of two years with clinical, neuropsychological, and radiological assessments.
Main Results:
- Median seizure frequency reduced from 6.16 to 0.33 per month at two years.
- 65% of patients achieved seizure freedom.
- Transient side effects were reported, but no permanent neurological deficits, though nine visual field deficits occurred.
Conclusions:
- GKS demonstrates good short-to-middle-term safety and efficacy for MTLE.
- Delayed seizure cessation is a notable disadvantage of GKS.
- Longer follow-up is necessary to confirm sustained efficacy and safety.