Gamma Knife radiosurgery for epilepsy associated with cavernous hemangiomas:: A retrospective study of 49 cases
Gamma Knife radiosurgery for epilepsy associated with cavernous hemangiomas:: A retrospective study of 49 cases
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DOI：
10.1159/000056435
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发表时间：
1999-01-01
影响因子：
1.7
通讯作者：
Pendl, G
中科院分区：
文献类型：
--
作者：
Bartolomei, F;Régis, J;Pendl, G
为评价伽玛刀放射外科(GKRS)治疗海绵状血管瘤(CH)耐药癫痫的疗效，对GKRS前癫痫病程平均为7.5±9.3年进行了多中心的回顾性研究。平均发作次数为6.9+/-14次/月。平均边缘剂量为19.2+/-4.4Gy11.3~36Gy.平均随访23.7+/-13个月。在最近的随访检查中，26例(53%)患者无癫痫发作(Engel‘s I级)，其中24例(49%)在IA级(49%)，2例(4%)患者(4%)有间歇性房颤(IB级)。10例(20%)患者癫痫发作次数显著减少，为IIB级。其余13例(2.6%)患者病情改善很小或没有改善。位于内侧的颞骨位置与失败风险较高相关。相反，所有中央区CH患者均无癫痫发作。观察到两个严重但短暂的并发症。一名患者有出血，另一名患者出现放射性水肿并一过性失语。这是第一次证明GKRS可以安全有效地治疗与CH相关的癫痫。当CH位置与致痫区域存在良好的电-临床相关性时，可达到控制癫痫发作的目的。我们的研究结果表明，GKRS可用于治疗位于高功能区，特别是中央区的癫痫.版权所有(C)1999 S.Karger AG.巴塞尔。
A retrospective multicenter study was performed to evaluate the effectiveness of Gamma Knife radiosurgery (GKRS) in the treatment of drug resistant epilepsy associated with cavernous hemangiomas (CH).The mean duration of epilepsy before GKRS was 7.5 +/- 9.3 years. The mean frequency of seizures was 6.9 +/- 14/month. The mean marginal dose was 19.2 +/- 4.4 Gy (range 11.3 to 36 Gy). The mean follow up was 23.7 +/- 13 months. At the most recent follow-up examination, 26 (53%) patients were seizure-free (Engel's class I) including 24 in class IA (49%) and two (4%) patients with occasional auras (class IB, 4%). A highly significant decrease in the number of seizures was achieved in 10 (20%) patients, which is class IIB. The remaining 13 (2.6%) patients showed little or no improvement. A medial temporal location was associated with a higher risk of failure. In contrast, all patients with central region CH were seizure free. Two severe but transient complications were observed. There was hemorrhage in one patient and another patient suffered from radio-induced edema with transient aphasia.This series is the first demonstrating that GKRS can be used safely and efficiently to treat epilepsy associated to CH. Seizure control can be reached when a good electro-clinical correlation exists between CH location and epileptogenic zone. Our findings suggest that GKRS can be used to treat epilepsy for CH located in highly functional areas, particularly the central region.Copyright (C) 1999 S. Karger AG. Basel.