First selective amygdalohippocampal radiosurgery for 'mesial temporal lobe epilepsy'

All the well-documented radiosurgery of epilepsy cases are secondary epilepsies with space-occupying lesions. These results have prompted the idea of testing radiosurgery as a new way of treating epilepsy without space-occupying lesions. We have treated 4 patients with 'mesial temporal lobe epilepsy'. The preoperative evaluation programme was one we usually perform for patients selected for microsurgery of epilepsy. We report the baselines of this treatment, the radiosurgical protocol details, and preliminary results for the first patient treated (follow-up 16 months). Since treatment, the patient has been seizure free, but it is too soon to draw long-term conclusions about the efficiency of the radiosurgery of epilepsy. Morphological (MRI) and functional (PET scan) changes are discussed in relation to our technical choices. Our amygdaloentorhinohippocampal target has been selectively injured.