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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
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Morphological changes after radiosurgery for mesial temporal lobe epilepsy
Zdeněk Vojtěch1, Hana Malíková2, Martin Syrůček3
1Department of Neurology, Na Homolce Hospital, Roentgenova 2, 15030, Prague 5-Motol, Czech Republic. zdenek.vojtech@homolka.cz.
Acta Neurochirurgica
|August 17, 2015
Summary
Gamma Knife radiosurgery for mesial temporal lobe epilepsy frequently causes delayed complications and morphological changes. Its unproven seizure control efficacy necessitates careful consideration for future studies.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Reviewing morphological changes in patients with mesial temporal lobe epilepsy (MTLE) after Gamma Knife radiosurgery (GKRS).
- Assessing long-term outcomes and complications following GKRS for MTLE.
Purpose of the Study:
- To evaluate the morphological developments and complications associated with GKRS in MTLE patients.
- To correlate morphological changes with seizure control and treatment efficacy.
Main Methods:
- Retrospective review of 14 MTLE patients treated with GKRS between 1995-1999.
- Analysis of seizure outcomes, magnetic resonance imaging (MRI), and histopathology specimens.
- Comparison of outcomes between operated and unoperated patients.
Main Results:
- 11 patients developed radionecrosis, more frequent with higher doses.
- Significant complications included edema, uncal herniation, and intracranial hypertension.
- Persistent postcontrast enhancement, pseudocysts, neoangiogenesis, and microbleeds were observed long-term.
- Seizure outcome varied, with some patients achieving Engel class IA post-surgery.
Conclusions:
- GKRS for MTLE is associated with frequent early and late delayed complications.
- Morphological signs indicate a risk for developing late complications.
- The unproven antiseizure efficacy and complication risks require careful consideration for future GKRS studies in MTLE.
