Gamma Knife Treatment after Failure of Epilepsy Surgery?? Report of Two Cases |
Deok-Joo Rhee, Jung-Il Lee, Seung-Bong Hong, Munhyang Lee, Seung-Chyul Hong |
Department of Neurosurgery, Neurology and Pediatrics Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
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Abstract |
Objective s: Gamma knife radiosurgery (GKRS) may be a potential option for epilepsy, which produces little morbidity and acceptable results. The authors report the results of GKRS in two patients who underwent after failure of epilepsy surgery.
Methods Two patients, a 14-year-old male and a 14-year-old female, presented with medically and surgically intractable epilepsy and increasing episodes of secondary generalized seizures. One patient underwent callosotomy due to atonic seizure but symptom was not reduced. GKRS was performed body and splenium of collpus callosum. The other patient underwent right occipital lesionectomy with dysembryoplastic neuroepithelial tumor (DNT) removal. However, there were persistent episodes of aura. GKRS was performed, covering tumor and surrounding area.
Results Follow-up periods were 18 months in the female patient and 14 months in the male. In the first case, her episode of aura was disappeared at 6 months after GKRS. In the other case, his episode of seizure was reduced immediately after GKRS but some weeks later, the seizure frequency was become same as before GKRS. Eight months later, frequency of seizure was reduced about 80%.
Conclusion Gamma knife surgery can be a safe and effective alternative treatment modality for the seizure control in patients with DNT and collpus callosotomy in which surgical access is difficult. The outcomes suggest that radiosurgical epilepsy surgery may be a promising alternative treatment to operation. |
Key Words:
Gamma knife surgery, Epilepsy, Callosotomy, Dysembryoplastic neuroepithelial tumor. |
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