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Advances in Epilepsy Surgery and Radiosurgery pp 49–55Cite as

Gamma-Knife Radiosurgery of Mesiotemporal Tumour Epilepsy Observations and Long Term Results

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Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 84))

Summary

Purpose. The efficacy of radiosurgery in cases of mesiotemporal tumours associated with long standing epilepsy has not clearly been documented up to now. The authors present a retrospective analysis of 19 cases treated by Gamma-Knife radiosurgery (GKRS) for mesiotemporal tumour epilepsy.

Methods. Between 1992 and 1997 19 patients (12 male and 7 female) with a mean age of 31 years (5–72) and mesiotemporal tumour-induced epilepsy of a mean duration of 8.6 years (0.9–28) were treated by GKRS. All tumours were within the mesiotemporal structures and the pathohistology proven by biopsy or resective procedure revealed 15 (79%) low grade astrocytomas, 3 (16%) gangliogliomas and 1 (5%) cavernoma. Beside tumour control, the main aim of GKRS was alleviation of epilepsy by irradiating the presumed epileptic foci outside the tumour volume. The 50% isodose volumes surrounding the tumours measured a mean of 6.2 ccm (1.1–18 ccm). Doses given at marginal isodoses ranged from 12 to 30 Gy (mean 17.3 Gy). The outcome with respect to epileptic seizures was evaluated by the Engel classification.

Results. After a follow-up (FU) of 1.7 to 9.7 years (mean 6.5 years) 11 patients (57.9%) were significantly ameliorated (Engel I and Engel II), 7 patients (36.8%) worthwhile improved (Engel III) and 1 patient (5.3%) unchanged. In 11 patients (58%) radiosurgically induced image changes were seen on MRI.

Interpretation. Although microsurgical approach guided by electrocorticography (EcoG) is the state of art for treatment of mesiotemporal tumour epilepsy, GKRS can be used as a non-invasive, safe and effective alternative to resective surgery for selected cases.

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Authors and Affiliations

  1. Department of Neurosurgery, Karl-Franzens University, Auenbruggerplatz 29, A-8036, Graz, Austria

    Oskar Schröttner M.D., F. Unger, H. G. Eder & G. Pendl

  2. Department of Neurology, Karl-Franzens University, Graz, Austria

    M. Feichtinger

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  1. Oskar Schröttner M.D.
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  2. F. Unger
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  3. H. G. Eder
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  4. M. Feichtinger
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  5. G. Pendl
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Editors and Affiliations

  1. Universitätsklinik für Neurochirurgie, Karl-Franzens Universität, Graz, Austria

    B. Sutter  & O. Schröttner  & 

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© 2002 Springer-Verlag Wien

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Schröttner, O., Unger, F., Eder, H.G., Feichtinger, M., Pendl, G. (2002). Gamma-Knife Radiosurgery of Mesiotemporal Tumour Epilepsy Observations and Long Term Results. In: Sutter, B., Schröttner, O. (eds) Advances in Epilepsy Surgery and Radiosurgery. Acta Neurochirurgica Supplements, vol 84. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6117-3_5

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  • DOI: https://doi.org/10.1007/978-3-7091-6117-3_5

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7296-4

  • Online ISBN: 978-3-7091-6117-3

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