Aileen McGonigal1, Arjun Sahgal2, Antonio De Salles3, Motohiro Hayashi4, Marc Levivier5, Lijun Ma6, Roberto Martinez7, Ian Paddick8, Samuel Ryu9, Ben J Slotman10, Jean Régis11. 1. Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes and CHU Timone, Service de Neurophysiologie Clinique, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France. Electronic address: aileen.mcgonigal@univ-amu.fr. 2. Department of Radiation Oncology, University of Toronto, Odette Cancer Centre, Toronto, ON, Canada. 3. Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA; HCor Neuroscience, Sao Paulo, SP, Brazil. 4. Department of Neurosurgery, Tokyo Women's Medical University, Toyko, Japan. 5. Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 6. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA. 7. Department Neurosurgery, Ruber Internacional Hospital, Madrid, Spain. 8. Queen Square Radiosurgery Centre, National Hospital for Neurology and Neurosurgery, London, UK. 9. Department of Radiation Oncology and Neurosurgery, Stony Brook University, Stony Brook, NY, USA. 10. Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. 11. Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes & CHU Timone Department of Functional Neurosurgery, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France.
Abstract
BACKGROUND: While there are many reports of radiosurgery for treatment of drug-resistant epilepsy, a literature review is lacking. OBJECTIVE: The aim of this systematic review is to summarize current literature on the use of stereotactic radiosurgery (RS) for treatment of epilepsy. METHODS: Literature search was performed using various combinations of the search terms "radiosurgery", "stereotactic radiosurgery", "Gamma Knife", "epilepsy" and "seizure", from 1990 until October 2015. Level of evidence was assessed according to the PRISMA guidelines. RESULTS: Fifty-five articles fulfilled inclusion criteria. Level 2 evidence (prospective studies) was available for the clinical indications of mesial temporal lobe epilepsy (MTLE) and hypothalamic hamartoma (HH) treated by Gamma Knife (GK) RS. For remaining indications including corpus callosotomy as palliative treatment, epilepsy related to cavernous malformation and extra-temporal epilepsy, only Level 4 data was available (case report, prospective observational study, or retrospective case series). No Level 1 evidence was available. CONCLUSION: Based on level 2 evidence, RS is an efficacious treatment to control seizures in MTLE, possibly resulting in superior neuropsychological outcomes and quality of life metrics in selected subjects compared to microsurgery. RS has a better risk-benefit ratio for small hypothalamic hamartomas compared to surgical methods Delayed therapeutic effect resulting in ongoing seizures is associated with morbidity and mortality risk. Lack of level 1 evidence precludes the formation of guidelines at present.
BACKGROUND: While there are many reports of radiosurgery for treatment of drug-resistant epilepsy, a literature review is lacking. OBJECTIVE: The aim of this systematic review is to summarize current literature on the use of stereotactic radiosurgery (RS) for treatment of epilepsy. METHODS: Literature search was performed using various combinations of the search terms "radiosurgery", "stereotactic radiosurgery", "Gamma Knife", "epilepsy" and "seizure", from 1990 until October 2015. Level of evidence was assessed according to the PRISMA guidelines. RESULTS: Fifty-five articles fulfilled inclusion criteria. Level 2 evidence (prospective studies) was available for the clinical indications of mesial temporal lobe epilepsy (MTLE) and hypothalamic hamartoma (HH) treated by Gamma Knife (GK) RS. For remaining indications including corpus callosotomy as palliative treatment, epilepsy related to cavernous malformation and extra-temporal epilepsy, only Level 4 data was available (case report, prospective observational study, or retrospective case series). No Level 1 evidence was available. CONCLUSION: Based on level 2 evidence, RS is an efficacious treatment to control seizures in MTLE, possibly resulting in superior neuropsychological outcomes and quality of life metrics in selected subjects compared to microsurgery. RS has a better risk-benefit ratio for small hypothalamic hamartomas compared to surgical methods Delayed therapeutic effect resulting in ongoing seizures is associated with morbidity and mortality risk. Lack of level 1 evidence precludes the formation of guidelines at present.
Authors: Daniel M Trifiletti; Henry Ruiz-Garcia; Alfredo Quinones-Hinojosa; Rohan Ramakrishna; Jason P Sheehan Journal: J Neurooncol Date: 2021-02-21 Impact factor: 4.130
Authors: Pierre Bourdillon; S Ferrand-Sorbet; C Apra; M Chipaux; E Raffo; S Rosenberg; C Bulteau; N Dorison; O Bekaert; V Dinkelacker; C Le Guérinel; M Fohlen; G Dorfmüller Journal: Neurosurg Rev Date: 2020-04-21 Impact factor: 3.042