| Long-term efficacy of gamma knife radiosurgery in mesial temporal lobe epilepsy. | |
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MedLine Citation:
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PMID: 18401026 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Gamma knife (GK) radiosurgery has been proposed as an alternative to classic microsurgery in mesial temporal lobe epilepsy (MTLE). Short-term follow-up studies have reported encouraging results, but long-term efficacy is not known. OBJECTIVE: To report the efficacy and tolerance of GK radiosurgery in MTLE after a follow-up > 5 years. METHODS: Patients with a follow-up > 5 years presenting with MTLE and treated with a marginal dose of 24 Gy were included in the study. RESULTS: Fifteen patients were included. Eight were treated on the left side, and 7 were treated on the right. The mean follow-up was 8 years (range 6-10 years). At the last follow-up, 9 of 16 patients (60%) were considered seizure free (Engel Class I) (4/16 in Class IA, 5/16 in Class IB). Seizure cessation occurred with a mean delay of 12 months (+/- 3) after GK radiosurgery, often preceded by a period of increasing aura or seizure occurrence (6/15 patients). The mean delay of appearance of the first neuroradiologic changes was 12 months (+/- 4). Nine patients (60%) experienced mild headache and were placed on corticosteroid treatment for a short period. All patients who were initially seizure free experienced a relapse of isolated aura (10/15, 66%) or complex partial seizures (10/15, 66%) during antiepileptic drug tapering. Restoration of treatment resulted in good control of seizures. CONCLUSION: Gamma knife radiosurgery is an effective and safe treatment for mesial temporal lobe epilepsy. Results are maintained over time with no additional side effects. Long-term results compare well with those of conventional surgery. |
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Authors:
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F Bartolomei; M Hayashi; M Tamura; M Rey; C Fischer; P Chauvel; J Régis |
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Publication Detail:
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Type: Journal Article Date: 2008-04-09 |
Journal Detail:
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Title: Neurology Volume: 70 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-06 Completed Date: 2008-06-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1658-63 Citation Subset: AIM; IM |
Affiliation:
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Département de Neurophysiologie Clinique, Assistance Publique-Hôpitaux de Marseille, Hôpital Timone, Marseille, France. fbartolo@medecine.univ-mrs.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Atrophy / etiology, pathology Cohort Studies Drug Resistance Epilepsy, Temporal Lobe / physiopathology, surgery* Female Follow-Up Studies Humans Magnetic Resonance Imaging Male Middle Aged Postoperative Complications / etiology, physiopathology, prevention & control* Radiation Dosage Radiosurgery / adverse effects, standards, statistics & numerical data* Recurrence / prevention & control Temporal Lobe / pathology, physiopathology, radiation effects Time Treatment Outcome Vision Disorders / etiology |
| Comments/Corrections | |
Comment In:
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Neurology. 2008 May 6;70(19):1654-5
[PMID:
18458224
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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