Gamma Knife Radiosurgery In Patients With Recurrent Temporal Lobe Epilepsy After Resective Surgery

Kyo Jung Lee1, Seok Ho Hong1, Jin Kyung Kim1, Joong Ko Kang1, Tae-Sung Ko1, Sang-Ahm Lee1

1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,

Keywords: gamma knife, mesial temporal sclerosis, epilepsy, outcome, resection

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     Persistent or recurrent temporal lobe epilepsy after mesial temporal resection has been challenging issue because of its potential clinical burden.
     We analyzed the outcome of Gamma knife radiosurgery as a salvage therapeutic option for temporal lobe epilepsy after resective surgery.
     Between 2004 and 2008, eight patients who suffered from remained seizures after standard anterior temporal lobectomy underwent Gamma knife radiosurgery.
     Radiation was delivered mainly to the posterior mesial temporal structures, including the tail of hippocampus and posterior port of parahipppocampal gyrus, with the marginal dose of 24Gy to the 50% isodose line. Seizure outcome was evaluated at least for two year in all patients.
      Five out of 8 patients (62.5%) were seizure-free at two year after Gamma knife radiosurgery (Engel class I) and afterwards. Two patients (25.0%) were evaluated to have rare seizures (Engel class II) at two year after Gamma knife radiosurgery, and one (12.5%) had experienced seizures of fluctuating, but decreased frequency (rated as Engel class III) . None of the patients had aggravation of seizures. There was no adverse event related to Gamma knife radiosurgery, clinically or in the imaging studies checked at one year after Gamma knife radiosurgery.
     This is a retrospective study.
     Gamma knife radiosurgery could be an efficacious therapeutic option for temporal lobe epilepsy in patients with persistent or recurrent seizures following resective surgery.
     Further clinical trials are needed to elucidate actual clinical efficacy, and to determine optimal radiosurgical regimen.


Project Roles:

K. Lee (), S. Hong (), J. Kim (), J. Kang (), T. Ko (), S. Lee ()