Whang C J, Kwon Y
Department of Neurological Surgery, Asan Medical Center, Seoul, Korea.
Stereotact Funct Neurosurg. 1996;66 Suppl 1:349-56. doi: 10.1159/000099735.
From June 1990 to May 1995, 31 patients with epilepsy were treated by stereotactic Gamma Knife radiosurgery at the Asan Medical center. The effect of radiosurgery for epilepsy was assessed in 23 patients followed for longer than 1 year. The seizures were medically intractable in all patients: generalized in 13 cases, complex partial in 6 cases and partial in 4 cases. The duration of epilepsy ranged from 1 to 25 years, with a mean of 11.6 years. Electroencephalography and magnetic resonance imaging (MRI) were performed in all patients to identify and localize the seizure focus. The lesions on MRI were nonprogressive and less than 2.0 cm in diameter. At follow-up, 12 patients had an excellent result (class I according to Engel's classification). In 3 of these patients, antiepileptic medication was discontinued. In a further 2 patients, the seizure frequency decreased (class II and III). In the remaining 9 patients, the frequency of seizures was unchanged (class IV). Radiation-induced edema did not seem to affect the outcome with respect to seizure control. The role of radiosurgery in the treatment of epilepsy is still unclear. It is premature to draw any definite conclusions about its efficacy for intractable epilepsy in our series. However, even this small group certainly suggests the possibility of a new safe treatment method in selected patients.
1990年6月至1995年5月，31例癫痫患者在峨山医疗中心接受了立体定向伽玛刀放射外科治疗。对23例随访超过1年的患者评估了放射外科治疗癫痫的效果。所有患者的癫痫发作均难以通过药物控制：全身性发作13例，复杂部分性发作6例，部分性发作4例。癫痫病程为1至25年，平均11.6年。所有患者均进行了脑电图和磁共振成像（MRI）检查，以确定并定位癫痫病灶。MRI上的病灶无进展，直径小于2.0 cm。随访时，12例患者效果极佳（根据恩格尔分类为I级）。其中3例患者停用了抗癫痫药物。另有2例患者癫痫发作频率降低（II级和III级）。其余9例患者癫痫发作频率未变（IV级）。放射诱导的水肿似乎对癫痫控制效果没有影响。放射外科在癫痫治疗中的作用仍不明确。就我们的系列研究而言，对其治疗难治性癫痫的疗效得出任何明确结论都为时过早。然而，即使是这个小样本组也肯定提示了在特定患者中采用一种新的安全治疗方法的可能性。
