Download PDF
Minim Invasive Neurosurg 2001; 44(1): 43-46
DOI: 10.1055/s-2001-13586
ORIGINAL PAPER
Georg Thieme Verlag Stuttgart · New York

Successful Radiosurgical Treatment of Lesional Epilepsy of Mesial Temporal Origin

H. Kurita1 , I. Suzuki1 , M. Shin1 , K. Kawai1 , M. Tago2 , T. Momose2 , T. Kirino1
  • 1Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  • 2Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Further Information

Publication History

Publication Date:
31 December 2001 (online)

    Permissions and Reprints

We report a case of successful radiosurgical treatment of lesional epilepsy of mesial temporal origin. A patient presented with a 2-year history of medically intractable complex partial seizures associated with a mesial temporal angioma. Interictal scalp EEG and MEG showed focal epileptiform activity around the lesion. 99mTc-HMPAO-SPECT and 18F-FDG-PET demonstrated depressed blood flow and glucose metabolism in the corresponding temporal lobe. The patient underwent gamma knife radiosurgery for the causative lesion with a low marginal dose of 18 Gy. After treatment, the partial attack ceased without shrinkage of the lesion or peri-lesional parenchymal radiation injury.

Key words:

Radiosurgery - Temporal lobe epilepsy - PET/SPECT

References

  • 1 Kurita H, Kawamoto S, Suzuki I, Sasaki T, Tago M, Terahara A, Kirino T. Control of epilepsy associated with cerebral arteriovenous malformations after radiosurgery.  J Neurol Neurosurg Psychiatry. 1998;  65 648-655
    CrossrefPubMedGoogle Scholar
  • 2 Heikkinen E R, Konnov B, Melnikov L, Yalynych N, Zubkov Y N, Garmashov Y A, Pak V A. Relief of epilepsy by radiosurgery of cerebral arteriovenous malformations.  Stereotact Funct Neurosurg. 1989;  53 157-166
    PubMedGoogle Scholar
  • 3 Warnke P C, Berlis A, Weyerbrock A, Ostertag C B. Significant reduction of seizure incidence and increase of benzodiazepine receptor density after interstitial radiosurgery in low-grade gliomas.  Acta Neurochir. 1997;  S68 90-92
    PubMedGoogle Scholar
  • 4 Rogers L R, Morris H H, Lupica K. Effect of cranial irradiation on seizure frequency in adults with low-grade astrocytoma and medically intractable epilepsy.  Neurology. 1993;  43 1599-1601
    PubMedGoogle Scholar
  • 5 Barcia J A, Barcia-Salorio J L, Lopez-Gomez L, Hernandez G. Stereotactic radiosurgery may be effective in the treatment of idiopathic epilepsy: report on the methods and results of eleven cases.  Stereotact Funct Neurosurg. 1994;  63 271-279
    PubMedGoogle Scholar
  • 6 Heikkinen E R, Heikkinen M I, Sotaniemi K. Stereotactic radiotherapy instead of conventional epilepsy surgery. A case report.  Acta Neurochir. 1992;  119 159-160
    CrossrefPubMedGoogle Scholar
  • 7 Regis J, Semah F, Bryan R N, Levrier O, Rey M, Samson Y, Peragut J C. Early and delayed MR and PET changes after selective temporomesial radiosurgery in mesial temporal epilepsy.  AJNR Am J Neuroradiol. 1999;  20 213-216
    PubMedGoogle Scholar
  • 8 Abou-Khalil B W, Siegel G J, Sackellares J C, Gilman S, Hichwa R, Marshall R. Positron emission tomography studies of cerebral glucose metabolism in chronic partial epilepsy.  Ann Neurol. 1987;  22 480-486
    CrossrefPubMedGoogle Scholar
  • 9 Engel Jr J, Brown W J, Kuhl D E, Phelps M E, Mazziotta J C, Crandall P H. Pathological findings underlying focal temporal lobe hypometabolism in partial epilepsy.  Ann Neurol. 1982;  12 518-528
    CrossrefPubMedGoogle Scholar
  • 10 Ryvlin P, Philippon B, Cinotti L, Froment J C, Le Bars D, Mauguière F. Functional neuroimaging strategy in temporal lobe epilepsy: a comparative study of 18FDG-PET and 99mTc-HMPAO-SPECT.  Ann Neurol. 1992;  31 650-656
    CrossrefPubMedGoogle Scholar

Corresponding Author

H Kurita, M.D., Ph.D 

Department of Neurosurgery
Kyorin University School of Medicine

6-20-2 Shinkawa
Mitaka City
Tokyo 181-8611
Japan

Phone: Phone:+81-422-47-5511

Fax: Fax:+81-422-43-4715

Email: E-mail:hkurita-tky@umin.ac.jp

      >