Long-term outcome of gamma-knife surgery in temporal lobe epilepsy

Détails

ID Serval
serval:BIB_BE3221F54A9A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Long-term outcome of gamma-knife surgery in temporal lobe epilepsy
Périodique
Epilepsy Res
Auteur(s)
Rheims S., Fischer C., Ryvlin P., Isnard J., Guenot M., Tamura M., Regis J., Mauguiere F.
ISSN
0920-1211 (Print)
ISSN-L
0920-1211
Statut éditorial
Publié
Date de publication
07/2008
Volume
80
Numéro
1
Pages
23-9
Langue
anglais
Notes
Rheims, Sylvain
Fischer, Catherine
Ryvlin, Philippe
Isnard, Jean
Guenot, Marc
Tamura, Manubu
Regis, Jean
Mauguiere, Francois
eng
Clinical Trial
Netherlands
Epilepsy Res. 2008 Jul;80(1):23-9. doi: 10.1016/j.eplepsyres.2008.03.003.
Résumé
PURPOSE: Indication of gamma-knife surgery (GKS) in temporal lobe epilepsy (TLE) remains a matter of debate. Either positive or negative results have been reported in studies with a maximum follow-up of 24 months. No long-term data have been published yet. METHODS: We collected data from 15 TLE patients who underwent GKS and whose follow-up was longer than 24 months. Localisation and extension of the epileptogenic zone (EZ) were assessed by SEEG in eight patients. Ten patients were presenting with mesial TLE (mTLE) while in the other five SEEG showed that the EZ was extending beyond mesio-temporal structures. GKS procedure was targeted to the EZ at a dose of 21.1+/-2.6Gy at the margin. RESULTS: The mean duration of the follow-up was 60+/-22.3 months. At last follow-up, seven patients (46.7%) were free of disabling seizure. The last seizure following GKS occurred on average after a delay of 19.75+/-20.62 months. No patient suffered recurrent seizures after a long period free of disabling seizures. No significant prognostic predictor could be individualized in this population. However, 6 of the 10 patients with mTLE (60%) were seizure free whereas only 1 of the 5 (20%) whose EZ was more extended exhibited the same seizure outcome. CONCLUSION: When a positive outcome is achieved, the risk of seizure recurrence remains low at long term. In patients with typical mTLE, long-term GKS results may be closed to those observed after conventional surgery. Conversely, this procedure should not be proposed to patients in whom SEEG results suggest that the EZ is not restricted to mesial temporal structures.
Mots-clé
Adolescent, Adult, Aged, Epilepsy, Temporal Lobe/*surgery, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Radiosurgery/*methods, Treatment Outcome
Pubmed
Création de la notice
29/11/2018 13:37
Dernière modification de la notice
20/08/2019 16:32
Données d'usage