Gamma knife radiosurgery for callosotomy in children with drug-resistant epilepsy.

Abstract

OBJECTIVES:

Gamma knife radiosurgery as a noninvasive procedure is increasingly used as a treatment option in patients with intractable seizures. We investigated efficacy and safety of gamma knife radiosurgery (GKRS) for callosotomy in children.

MATERIALS AND METHODS:

Between 2000 and 2004 three children between 4 and 14 years (mean 8 years) underwent radiosurgical callosotomy. One child presented with Lennox-Gastaut syndrome, two with hemispheric cortical dysplasia. These two children underwent functional hemispherotomy before GKRS. GKRS was performed with a marginal dose of 55-60 Gy on the 50% isodose.

RESULTS:

Mean follow-up was 35 months. Radiosurgical callosotomy was ineffective in one child with the Lennox-Gastaut syndrome, whereas in the remaining two children, a 100% seizure reduction of generalized tonic-clonic seizures, 20-70% reduction of partial seizures, and a progress in mental and physical development was achieved. No postradiosurgical side effects were observed in all children.

CONCLUSION:

Radiosurgical callosotomy might be offered after hemispherotomy to complete callosal resection. However, larger number of patients and longer follow-ups are needed to draw final conclusions.

• Authors: Hans Georg Eder, Michael Feichtinger, Tom Pieper, Senta Kurschel, Oskar Schroettner
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 22 Issue 8 Pg. 1012-7 (Aug 2006) ISSN: 0256-7040 [Print] Germany
• PMID: 16770617 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Child
• Child, Preschool
• Corpus Callosum (surgery)
• Drug Resistance
• Epilepsy (drug therapy, pathology, surgery)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Radiosurgery (methods)
• Retrospective Studies
• Treatment Outcome