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Strahlentherapie bei arteriovenösen Malformationen assoziierten Epilepsien

Übersicht zur aktuellen Studienlage

Radiation therapy in ateriovenous malformation-associated epilepsy

Review of current studies

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Zusammenfassung

Nach Hirnblutungen stellen epileptische Anfälle mit ca. 30% das zweithäufigste Symptom von arteriovenösen Malformationen (AVM) dar. Die meisten Studien zur Strahlentherapie von AVM untersuchen die Reduktion der Blutungsinzidenz als Hauptzielkriterium. Dennoch gibt es klare Hinweise darauf, dass eine Radiotherapie auch den klinischen Verlauf einer symptomatischen Epilepsie bei AVM-Patienten günstig beeinflussen kann. Die vorliegenden Studien zu Patientenkohorten mit AVM-assoziierter Epilepsie erlauben Rückschlüsse auf die Risikofaktoren für das Auftreten einer Epilepsie bei AVM und auf strahlenbiologische Faktoren, die einen „antiepileptogenen“ Effekt bedingen könnten. Ziel dieser Übersichtsarbeit ist es, die bisher vorliegenden Daten zu diesen beiden Aspekten zusammenzufassen, um das Interesse an einer strahlentherapeutischen Epilepsietherapie zu vertiefen, das bereits durch die „γ-knife“-Therapie von mesialen Temporallappenepilepsien und die Strahlentherapie hypothalamischer Hamartome geweckt wurde.

Abstract

After a cerebral hemorrhage, epileptic seizures occurring in about 30% of patients represent the second most common symptom of ateriovenous malformations (AVM). Most studies concerning radiation therapy of AVM have examined the reduction of the incidence of bleeding as the main endpoint. However, there is clear evidence that radiotherapy can also favorably influence the clinical course of symptomatic epilepsy in patients with AVM. The reported studies on patient cohorts with AVM-associated epilepsy permit conclusions to be made about the risk factors for the occurrence of epilepsy in AVM and about the radiobiological factors which could cause an “antiepileptogenic” effect. The aim of this review is to summarize the present data about both aspects to deepen interest in radiotherapeutic techniques for treating epilepsy, which was already stimulated by the “γ-knife” therapy for mesial temporal lobe epilepsies and the radiotherapy of hypothalamic hamartomas.

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Authors and Affiliations

  1. Klinik für Neurologie, Epilepsiezentrum Marburg (EZM), Universitätsklinikum Gießen und Marburg GmbH, Rudolf-Bultmann-Str. 8, 35039, Marburg, Deutschland

    E. Reich &  F. Rosenow

  2. Klinik für Strahlentherapie und Radioonkologie, Epilepsiezentrum Marburg (EZM), UKGM GmbH, Standort Marburg und Philipps-Universität Marburg, Marburg, Deutschland

    E. Reich & R. Engenhardt-Cabillic

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  1. E. Reich
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  2. R. Engenhardt-Cabillic
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  3. F. Rosenow
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Correspondence to F. Rosenow.

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Reich, E., Engenhardt-Cabillic, R. & Rosenow, F. Strahlentherapie bei arteriovenösen Malformationen assoziierten Epilepsien. Z. Epileptol. 23, 238–243 (2010). https://doi.org/10.1007/s10309-010-0135-9

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  • DOI: https://doi.org/10.1007/s10309-010-0135-9

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