Dr. Robert Goodman from our Epilepsy Center was part of a multi-center trial on the use of Gamma Knife Radiosurgery as an alternative to open brain surgery to help Epileptics get rid of their seizures. Results from this trial have been published this year in the February issue of Annals of Neurology.
A Gamma Knife isn’t really a knife. It is a large, stationary machine that can generate a highly concentrated beam of radiation to target a specific location in the brain. It is often used in the treatment of brain tumors. The Gamma rays are painless and the procedure is most often done in an outpatient visit. Typically only one treatment is needed. In this trial the treatment was specifically directed to a location on one side of the brain where the seizures occurred.
Thirty people with epilepsy that have at least three seizures a month were asked if they wanted to be part of this trial. In the end, 26 patients completed the course of the study. These patients were each treated at one of 15 different centers across the country, including our Epilepsy Center here in New York. The patients were divided into two groups: one that received a high intensity dose and one that received a low intensity dose.
They were observed over a period of three years and about 60% of all these patients were completely seizure free by the end. This is comparable to the results of open brain surgery. The differences between the two groups were minimal but the high intensity group tended to have a higher chance of achieving seizure freedom.
What is interesting about the results using the Gamma Knife compared to open surgery is the time it takes to get results. With open surgery, seizures and accompanying auras are immediately stopped. With Gamma Knife Radiosurgery, it can take up to a year for the seizures to go away and in this study, the auras intensified for a brief time even after the seizures stopped.
In some cases, the Gamma Knife patients had an increase in headaches and slight decreases in verbal memory. Over all though, there were no significantly adverse effects from the procedure and the outcome was comparable to the results of open brain surgery without all the risks and complications that entails.
To learn more look for the paper: A Multi-Center, Prospective Pilot Study of Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy: Seizure Response, Adverse Events, and Verbal Memory in the online journal Annals of Neurology Volume 65, Issue 2.
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