Document Detail


Long-term efficacy of gamma knife radiosurgery in mesial temporal lobe epilepsy.
MedLine Citation:
PMID:  18401026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
F Bartolomei; M Hayashi; M Tamura; M Rey; C Fischer; P Chauvel; J Régis
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Publication Detail:
Type:  Journal Article     Date:  2008-04-09
Journal Detail:
Title:  Neurology     Volume:  70     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-06     Completed Date:  2008-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1658-63     Citation Subset:  AIM; IM    
Affiliation:
Département de Neurophysiologie Clinique, Assistance Publique-Hôpitaux de Marseille, Hôpital Timone, Marseille, France. fbartolo@medecine.univ-mrs.fr
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MeSH Terms
Descriptor/Qualifier:
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:
Neurology. 2008 May 6;70(19):1654-5   [PMID:  18458224 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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