Radiosurgery for Drug-Resistant Epilepsies: State of the Art, Results, and Perspectives

  • Jean Régis
  • Romain Carron
  • Fabrice Bartolomei
  • Patrick Chauvel


Radiosurgery has been evaluated in our epilepsy surgery program since as early as 1992. Differential effect hypotheses based on the clinical observation of the safe antiepileptic effect of radiosurgery in AVM located in highly functional cortex have been demonstrated experimentally at the biochemical and cellular level. Memory sparing in dominant side mesial temporal lobe epilepsies (MTLE) suggests the possibility to reproduce this differential effect in clinical practice. Nowadays, with 20 years of experience in this field, numerous experimental studies and clinical prospective trials are substantiating a reasonable worldwide experience allowing us to define seriously what can be expected from radiosurgery in epilepsy. Several prospective trials have demonstrated the safety and efficacy of GKS in several kinds of epilepsies including MTLE and hypothalamic hamartomas. The role of radiosurgery in callosotomies and neocortical epilepsies is currently under evaluation. Clinical series and experimental data are suggesting that the use of radiosurgery is turning out to be beneficial only to those patients in whom strict preoperative definition of the extent of the epileptogenic zone has been achieved, and where strict rules of dose planning have been followed. As soon as these principles are not observed, the risk of treatment failure or untoward side effects increases dramatically. Long-term outcome is nowadays available for MTLE and hypothalamic hamartomas. Pure MTLE especially in patient with a high risk of verbal memory loss, or patients reluctant to a microsurgical intervention and patients with small Type I, II, and III hypothalamic hamartomas can be considered as current practice.


Gamma Knife Epilepsy Surgery Mesial Temporal Lobe Epilepsy Gamma Knife Radiosurgery Mammillary Body 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Regis J, Bartolomei F, Hayashi M, Chauvel P. Gamma Knife surgery, a neuromodulation therapy in epilepsy surgery! Acta Neurochir Suppl. 2002;84:37–47.PubMedGoogle Scholar
  2. 2.
    Regis J, Carron R, Park M. Is radiosurgery a neuromodulation therapy?: a 2009 Fabrikant award lecture. J Neurooncol. 2010;98:155–62.CrossRefPubMedGoogle Scholar
  3. 3.
    Régis J, Kerkerian-Legoff L, Rey M, Viale M, Porcheron D, Nieoullon A, Peragut J-C. First biochemical evidence of differential functional effects following gamma knife surgery. Stereotact Funct Neurosurg. 1996;66:29–38.CrossRefPubMedGoogle Scholar
  4. 4.
    Régis J, Bartolomei F, Rey M, Genton P, Dravet C, Semah F, Gastaut J, Chauvel P, Peragut J. Gamma knife surgery for mesial temporal lobe epilepsy. Epilepsia. 1999;40:1551–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Regis J, Levivier M, Hayashi M. Radiosurgery for intractable epilepsy. Tech Neurosurg. 2003;9:191–203.CrossRefGoogle Scholar
  6. 6.
    Régis J, Peragut JC, Rey M, Samson Y, Levrier O, Porcheron D, Regis H, Sedan R. First selective amygdalohippocampic radiosurgery for mesial temporal lobe epilepsy. Stereotact Funct Neurosurg. 1994;64:191–201.Google Scholar
  7. 7.
    Regis J, Rey M, Bartolomei F, Vladyka V, Liscak R, Schrottner O, Pendl G. Gamma knife surgery in mesial temporal lobe epilepsy: a prospective multicenter study. Epilepsia. 2004;45:504–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Regis J, Semah F, Bryan R, Levrier O, Rey M, Samson Y, Peragut J. Early and delayed MR and PET changes after selective temporomesial radiosurgery in mesial temporal lobe epilepsy. AJNR Am J Neuroradiol. 1999;20:213–6.PubMedGoogle Scholar
  9. 9.
    Tsuchitani S, Drummond J, Kamiryo T, Anzivino M, Chen Z, Steiner L, Lee K. Selective vulnerability of interneurons to low dosage radiosurgery. Presented at Society for Neuroscience Annual Meeting [abstract], New Orleans, 2003.Google Scholar
  10. 10.
    Quigg M, Rolston J, Barbaro NM. Radiosurgery for epilepsy: clinical experience and potential antiepileptic mechanisms. Epilepsia. 2012;53:7–15.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Bartolomei F, Hayashi M, Tamura M, Rey M, Fischer C, Chauvel P, Regis J. Long-term efficacy of gamma knife radiosurgery in mesial temporal lobe epilepsy. Neurology. 2008;70:1658–63.CrossRefPubMedGoogle Scholar
  12. 12.
    Barbaro NM, Quigg M, Broshek DK, Ward MM, Lamborn KR, Laxer KD, Larson DA, Dillon W, Verhey L, Garcia P, Steiner L, Heck C, Kondziolka D, Beach R, Olivero W, Witt TC, Salanova V, Goodman R. A multicenter, prospective pilot study of gamma knife radiosurgery for mesial temporal lobe epilepsy: seizure response, adverse events, and verbal memory. Ann Neurol. 2009;65:167–75.CrossRefPubMedGoogle Scholar
  13. 13.
    Regis J, Bartolomei J, Chauvel P. Epilepsy. Prog Neurol Surg. 2007;20:267–78.CrossRefPubMedGoogle Scholar
  14. 14.
    Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102:316–9.PubMedGoogle Scholar
  15. 15.
    Leksell L. Stereotaxic radiosurgery in trigeminal neuralgia. Acta Chir Scand. 1971;137:311–4.PubMedGoogle Scholar
  16. 16.
    Lindquist C, Kihlstrom L, Hellstrand E. Functional neurosurgery—a future for the gamma knife? Stereotact Funct Neurosurg. 1991;57:72–81.CrossRefPubMedGoogle Scholar
  17. 17.
    Talairach J, Bancaud J, Szikla G, Bonis A, Geler S, Vedrenne C. Approche nouvelle de la neurochirurgie de l’epilepsie. Méthodologie stéréotaxique et résultats thérapeutiques. Neurochirurgie. 1974;20:92–8.Google Scholar
  18. 18.
    Elomaa E. Focal irradiation of the brain: an alternative to temporal lobe resection in intractable focal epilepsy ? Med Hypotheses. 1980;6:501–3.CrossRefPubMedGoogle Scholar
  19. 19.
    Baudouin M, Stuhl L, Perrard A. Un cas d’épilepsie focale traité par la radiothérapie. Rev Neurol. 1951;84:60–3.PubMedGoogle Scholar
  20. 20.
    Von Wieser W. Die Roentgentherapie der traumatischen Epilepsie. Mschr Psychiat Neurol. 1939;101:422–4.Google Scholar
  21. 21.
    Heikkinen ER, Konnov B, Melnikow L. Relief of epilepsy by radiosurgery of cerebral arteriovenous malformations. Stereotact Funct Neurosurg. 1989;53:157–66.CrossRefPubMedGoogle Scholar
  22. 22.
    Rogers L, Morris H, Lupica K. Effect of cranial irradiation on seizure frequency in adults with low-grade astrocytoma and medically intractable epilepsy. Neurology. 1993;43:1599–601.CrossRefPubMedGoogle Scholar
  23. 23.
    Rossi G, Scerrati M, Roselli R. Epileptogenic cerebral low grade tumors: effect of interstitial stereotactic irradiation on seizures. Appl Neurophysiol. 1985;48:127–32.PubMedGoogle Scholar
  24. 24.
    Barcia Salorio JL, Roldan P, Hernandez G, Lopez Gomez L. Radiosurgery treatment of epilepsy. Appl Neurophysiol. 1985;48:400–3.PubMedGoogle Scholar
  25. 25.
    Gaffey C, Monotoya V, Lyman J, Howard J. Restriction of the spread of epileptic discharges in cats by mean of Bragg Peak intracranial irradiation. Int J Appl Radiat Isotope. 1981;32:779–87.CrossRefGoogle Scholar
  26. 26.
    Chen ZF, Kamiryo T, Henson SL, Yamamoto H, Bertram EH, Schottler F, Patel F, Steiner L, Prasad D, Kassell NF, Shareghis S, Lee KS. Anticonvulsant effects of gamma surgery in a model of chronic spontaneous limbic epilepsy in rats. J Neurosurg. 2001;94:270–80.CrossRefPubMedGoogle Scholar
  27. 27.
    Maesawa S, Kondziolka D, Dixon C, Balzer J, Fellows W, Lunsford L. Subnecrotic stereotactic radiosurgery controlling epilepsy produced by kainic acid injection in rats. J Neurosurg. 2000;93:1033–40.CrossRefPubMedGoogle Scholar
  28. 28.
    Mori Y, Kondziolka D, Balzer J, Fellows W, Flickinger J, Lunsford L, Thulborn K. Effects of stereotactic radiosurgery on an animal model of hippocampal epilepsy. Neurosurgery. 2000;46:157–65; discussion 165–58.CrossRefPubMedGoogle Scholar
  29. 29.
    Ronne-Engström E, Kihlström L, Flink R, Hillered L, Carlson H, Linquist C, Lin K. Gamma Knife surgery in epilepsy: an experimental model in the rat. Presented at European Society for Stereotactic and Functional Neurosurgery, 1993.Google Scholar
  30. 30.
    Barcia Salorio JL, Garcia JA, Hernandez G, Lopez Gomez L. Radiosurgery of epilepsy: long-term results. Presented at European Society for Stereotactic and Functional Neurosurgery, 1993.Google Scholar
  31. 31.
    Lindquist C. Gamma knife surgery in focal epilepsy. 1 year follow-up in 4 cases (Leksell Gamma Knife Society, Stockholm, 1992).Google Scholar
  32. 32.
    Lindquist C, Hellstrand E, Kilström L, Abraham-Fuchs K, Jernberg B, Wirth A. Stereotactic localisation of epileptic foci by magnetoencephalography and MRI followed by gamma surgery. Presented at International Stereotactic Radiosurgery Symposium, 1991.Google Scholar
  33. 33.
    Lindquist C, Kihlström L, Hellstrand E, Knutsson E. Stereotactic radiosurgery instead of conventional epilepsy surgery. Presented at European Society for Stereotactic and Functional Neurosurgery, 1993.Google Scholar
  34. 34.
    Regis J, Bartolomei F, Hayashi M, Roberts D, Chauvel P, Peragut JC. The role of gamma knife surgery in the treatment of severe epilepsies. Epileptic Disord. 2000;2:113–22.PubMedGoogle Scholar
  35. 35.
    Deonna T, Ziegler AL. Hypothalamic hamartoma, precocious puberty and gelastic seizures: a special model of “epileptic” developmental disorder. Epileptic Disord. 2000;2:33–7.PubMedGoogle Scholar
  36. 36.
    Kuzniecky R, Guthrie B, Mountz J, Bebin M, Faught E, Gilliam F, Liu HG. Intrinsic epileptogenesis of hypothalamic hamartomas in gelastic epilepsy. Ann Neurol. 1997;42:60–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Munari C, Kahane P, Francione S, Hoffmann D, Tassi L, Cusmai R, Vigevano F, Pasquier B, Betti OO. Role of the hypothalamic hamartoma in the genesis of gelastic fits (a video-stereo-EEG study). Electroencephalogr Clin Neurophysiol. 1995;95:154–60.CrossRefPubMedGoogle Scholar
  38. 38.
    Regis J, Bartolomei F, de Toffol B, Genton P, Kobayashi T, Mori Y, Takakura K, Hori T, Inoue H, Schrottner O, Pendl G, Wolf A, Arita K, Chauvel P. Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Neurosurgery. 2000;47:1343–51; discussion 1351–42.CrossRefPubMedGoogle Scholar
  39. 39.
    Regis J, Hayashi M, Eupierre LP, Villeneuve N, Bartolomei F, Brue T, Chauvel P. Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Acta Neurochir Suppl. 2004;91:33–50.PubMedGoogle Scholar
  40. 40.
    Regis J, Scavarda D, Tamura M, Nagayi M, Villeneuve N, Bartolomei F, Brue T, Dafonseca D, Chauvel P. Epilepsy related to hypothalamic hamartomas: surgical management with special reference to gamma knife surgery. Childs Nerv Syst. 2006;22:881–95.CrossRefPubMedGoogle Scholar
  41. 41.
    Regis J, Scavarda D, Tamura M, Villeneuve N, Bartolomei F, Brue T, Morange I, Dafonseca D, Chauvel P. Gamma knife surgery for epilepsy related to hypothalamic hamartomas. Semin Pediatr Neurol. 2007;14:73–9.CrossRefPubMedGoogle Scholar
  42. 42.
    Frattali CM, Liow K, Craig GH, Korenman LM, Makhlouf F, Sato S, Biesecker LG, Theodore WH. Cognitive deficits in children with gelastic seizures and hypothalamic hamartoma. Neurology. 2001;57:43–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Weissenberger AA, Dell ML, Liow K, Theodore W, Frattali CM, Hernandez D, Zametkin AJ. Aggression and psychiatric comorbidity in children with hypothalamic hamartomas and their unaffected siblings. J Am Acad Child Adolesc Psychiatry. 2001;40:696–703.CrossRefPubMedGoogle Scholar
  44. 44.
    Arita K, Ikawa F, Kurisu K, Sumida M, Harada K, Uozumi T, Monden S, Yoshida J, Nishi Y. The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma. J Neurosurg. 1999;91:212–20.CrossRefPubMedGoogle Scholar
  45. 45.
    Debeneix C, Bourgeois M, Trivin C, Sainte-Rose C, Brauner R. Hypothalamic hamartoma: comparison of clinical presentation and magnetic resonance images. Horm Res. 2001;56:12–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Valdueza JM, Cristante L, Dammann O, Bentele K, Vortmeyer A, Saeger W, Padberg B, Freitag J, Herrmann HD. Hypothalamic hamartomas: with special reference to gelastic epilepsy and surgery. Neurosurgery. 1994;34:949–58; discussion 958.CrossRefPubMedGoogle Scholar
  47. 47.
    Delalande O, Fohlen M. Disconnecting surgical treatment of hypothalamic hamartoma in children and adults with refractory epilepsy and proposal of a new classification. Neurol Med Chir (Tokyo). 2003;43:61–8.CrossRefGoogle Scholar
  48. 48.
    Palmini A, Chandler C, Andermann F, Costa Da Costa J, Paglioli-Neto E, Polkey C, Rosenblatt B, Montes J, Martinez JV, Farmer JP, Sinclair B, Aronyk K, Paglioli E, Coutinho L, Raupp S, Portuguez M. Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology. 2002;58:1338–47.CrossRefPubMedGoogle Scholar
  49. 49.
    Cascino GD, Andermann F, Berkovic SF, Kuzniecky RI, Sharbrough FW, Keene DL, Bladin PF, Kelly PJ, Olivier A, Feindel W. Gelastic seizures and hypothalamic hamartomas: evaluation of patients undergoing chronic intracranial EEG monitoring and outcome of surgical treatment. Neurology. 1993;43:747–50.CrossRefPubMedGoogle Scholar
  50. 50.
    Pascual-Castroviejo I, Moneo JH, Viano J, Garcia-Segura JM, Herguido MJ, Pascual Pascual SI. [Hypothalamic hamartomas: control of seizures after partial removal in one case]. Rev Neurol. 2000;31:119–22.PubMedGoogle Scholar
  51. 51.
    Rosenfeld JV, Harvey AS, Wrennall J, Zacharin M, Berkovic SF. Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy. Neurosurgery. 2001;48:108–18.PubMedGoogle Scholar
  52. 52.
    Watanabe T, Enomoto T, Uemura K, Tomono Y. Nose T: [Gelastic seizures treated by partial resection of a hypothalamic hamartoma]. No Shinkei Geka. 1998;26:923–8.PubMedGoogle Scholar
  53. 53.
    Wait SD, Abla AA, Killory BD, Nakaji P, Rekate HL. Surgical approaches to hypothalamic hamartomas. Neurosurg Focus. 2011;30:E2.CrossRefPubMedGoogle Scholar
  54. 54.
    Anderson JF, Rosenfeld JV. Long-term cognitive outcome after transcallosal resection of hypothalamic hamartoma in older adolescents and adults with gelastic seizures. Epilepsy Behav. 2010;18:81–7.CrossRefPubMedGoogle Scholar
  55. 55.
    Freeman JL, Zacharin M, Rosenfeld JV, Harvey AS. The endocrinology of hypothalamic hamartoma surgery for intractable epilepsy. Epileptic Disord. 2003;5:239–47.PubMedGoogle Scholar
  56. 56.
    Stabell KE, Bakke SJ, Egge A. Cognitive and neurological sequelae after stereoendoscopic disconnection of a hypothalamic hamartoma. A case study. Epilepsy Behav. 2012;24:274–8.CrossRefPubMedGoogle Scholar
  57. 57.
    Schulze-Bonhage A, Trippel M, Wagner K, Bast T, Deimling FV, Ebner A, Elger C, Mayer T, Keimer R, Steinhoff BJ, Spreer J, Fauser S, Ostertag C. Outcome and predictors of interstitial radiosurgery in the treatment of gelastic epilepsy. Neurology. 2008;71:277–82.CrossRefPubMedGoogle Scholar
  58. 58.
    Mathieu D, Deacon C, Pinard CA, Kenny B, Duval J. Gamma Knife surgery for hypothalamic hamartomas causing refractory epilepsy: preliminary results from a prospective observational study. J Neurosurg. 2010;113 Suppl:215–21.Google Scholar
  59. 59.
    Hayashi M, Regis J. Hori T: [Current treatment strategy with gamma knife surgery for mesial temporal lobe epilepsy]. No Shinkei Geka. 2003;31:141–55.PubMedGoogle Scholar
  60. 60.
    Ganz JC. Gamma knife radiosurgery and its possible relationship to malignancy: a review. J Neurosurg. 2002;97:644–52.PubMedGoogle Scholar
  61. 61.
    Glosser G, McManus P, Munzenrider J, Austin-Seymour M, Fullerton B, Adams J, Urie MM. Neuropsychological function in adults after high dose fractionated radiation therapy of skull base tumors. Int J Radiat Oncol Biol Phys. 1997;38:231–9.CrossRefPubMedGoogle Scholar
  62. 62.
    Clusmann H, Schramm J, Kral T, Helmstaedter C, Ostertun B, Fimmers R, Haun D, Elger CE. Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. J Neurosurg. 2002;97:1131–41.CrossRefPubMedGoogle Scholar
  63. 63.
    Stroup E, Langfitt J, Berg M, McDermott M, Pilcher W, Como P. Predicting verbal memory decline following anterior temporal lobectomy (ATL). Neurology. 2003;60:1266–73.CrossRefPubMedGoogle Scholar
  64. 64.
    Quigg M, Broshek DK, Barbaro NM, Ward MM, Laxer KD, Yan G, Lamborn K. Neuropsychological outcomes after Gamma Knife radiosurgery for mesial temporal lobe epilepsy: a prospective multicenter study. Epilepsia. 2011;52:909–16.PubMedCentralCrossRefPubMedGoogle Scholar
  65. 65.
    Cmelak AJ, Abou-Khalil B, Konrad PE, Duggan D, Maciunas RJ. Low-dose stereotactic radiosurgery is inadequate for medically intractable mesial temporal lobe epilepsy: a case report. Seizure. 2001;10:442–6.PubMedGoogle Scholar
  66. 66.
    Kawai K, Suzuki I, Kurita H, Shin M, Arai N, Kirino T. Failure of low-dose radiosurgery to control temporal lobe epilepsy. J Neurosurg. 2001;95:883–7.CrossRefPubMedGoogle Scholar
  67. 67.
    Yang KJ, Wang KW, Wu HP, Qi ST. Radiosurgical treatment of intractable epilepsy with low radiation dose. Di Yi Jun Yi Da Xue Xue Bao. 2002;22:645–7.PubMedGoogle Scholar
  68. 68.
    McCord MW, Buatti JM, Fennell EM, Mendenhall WM, Marcus Jr RB, Rhoton AL, Grant MB, Friedman WA. Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys. 1997;39:437–44.CrossRefPubMedGoogle Scholar
  69. 69.
    Barcia-Salorio JL, Barcia JA, Hernandez G, Lopez-Gomez L. Radiosurgery of epilepsy. Long-term results. Acta Neurochir Suppl (Wien). 1994;62:111–3.CrossRefGoogle Scholar
  70. 70.
    Hayashi M, Bartolomei F, Rey M, Farnarier P, Chauvel P, Regis J. MR changes after Gamma knife radiosurgery for Mesial Temporal Lobe Epilepsy: an evidence for the efficacy of subnecrotic doses. In: Kondziolka D, editor. Radiosurgery. Karger: Basel; 2002. p. 192–202.CrossRefGoogle Scholar
  71. 71.
    Grabenbauer GG, Reinhold C, Kerling F, Muller RG, Lambrecht U, Pauli E, Ganslandt O, Sauer R, Stefan H. Fractionated stereotactically guided radiotherapy of pharmacoresistant temporal lobe epilepsy. Acta Neurochir. 2002;84:65–70.Google Scholar
  72. 72.
    Stefan H, Hummel C, Grabenbauer GG, Muller RG, Robeck S, Hofmann W, Buchfelder M. Successful treatment of focal epilepsy by fractionated stereotactic radiotherapy. Eur Neurol. 1998;39:248–50.PubMedGoogle Scholar
  73. 73.
    Barcia Salorio JL, Vanaclocha V, Cerda M, Roldan P. Focus irradiation in epilepsy. Experimental study in the cat. Appl Neurophysiol. 1985;48:152.Google Scholar
  74. 74.
    Maesawa S, Kondziolka D, Balzer J, Fellows W, Dixon E, Lunsford LD. The behavioral and electroencephalographic effects of stereotactic radiosurgery for the treatment of epilepsy evaluated in the rat kainic acid model. Stereotact Funct Neurosurg. 1999;73:115.CrossRefPubMedGoogle Scholar
  75. 75.
    Bartolomei F, Wendling F, Bellanger JJ, Regis J, Chauvel P. Neural networks involving the medial temporal structures in temporal lobe epilepsy. Clin Neurophysiol. 2001;112:1746–60.CrossRefPubMedGoogle Scholar
  76. 76.
    Spencer S, Spencer D. Entorhinal-hippocampal interactions in medial temporal lobe epilepsy. Epilepsia. 1994;35:721–7.CrossRefPubMedGoogle Scholar
  77. 77.
    Flickinger JC. An integrated logistic formula for prediction of complications from radiosurgery. Int J Radiat Oncol Biol Phys. 1989;17:879–85.CrossRefPubMedGoogle Scholar
  78. 78.
    Régis J, Bartolomei F, Kida Y, Kobayashi T, Vladyka V, Liscàk R, Forster D, Kemeny A, Schröttner O, Pendl G. Radiosurgery of epilepsy associated with cavernous malformation: retrospective study in 49 patients. Neurosurgery. 2000;47:1091–7.CrossRefPubMedGoogle Scholar
  79. 79.
    Jones R, Heinemann U, Lambert J. The entorhinal cortex and generation of seizure activity: studies of normal synaptic transmission and epileptogenesis in vitro. In: Avanzini G, Engel J, Fariello R, Heinemann U, editors. Neurotransmitters in epilepsy. Amsterdam: Elsevier Science; 1992. p. 173–80.CrossRefGoogle Scholar
  80. 80.
    Wilson W, Swartzwelder HS, Anderson WW, Lewis DV. Seizure activity in vitro: a dual focus model. Epilepsy Res. 1988;2:289–93.CrossRefPubMedGoogle Scholar
  81. 81.
    Wieser HG, Siegel AM, Yasargil GM. The Zurich amygdalo-hippocampectomy series: a short up-date. Acta Neurochir Suppl (Wien). 1990;50:122–7.Google Scholar
  82. 82.
    Whang CJ, Kwon Y. Long-term follow-up of stereotactic gamma knife radiosurgery in epilepsy. Stereotact Funct Neurosurg. 1996;66 suppl 1:349–56.CrossRefPubMedGoogle Scholar
  83. 83.
    Kitchen N. Experimental and clinical studies on the putative therapeutic efficacy of cerebral irradiation (radiotherapy) in epilepsy. Epilepsy Res. 1995;20:1–10.CrossRefPubMedGoogle Scholar
  84. 84.
    Strasnick B, Glasscock ME, Haynes D. The natural history of untreated acoustic neuromas. Laryngoscope. 1994;104:1115–9.CrossRefPubMedGoogle Scholar
  85. 85.
    Simmons NE, Laws E. Gliomas occurrence after sellar irradiation: case report and review. Neurosurgery. 1998;42:172–8.CrossRefPubMedGoogle Scholar
  86. 86.
    Kaido T, Hoshida T, Uranishi R, Akita N, Kotani A, Nishi N, Sakaki T. Radiosurgery-induced brain tumor. Case report. J Neurosurg. 2001;95:710–3.CrossRefPubMedGoogle Scholar
  87. 87.
    Shamisa A, Bance M, Nag S, Tator C, Wong S, Noren G, Guha A. Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature. J Neurosurg. 2001;94:816–21.CrossRefPubMedGoogle Scholar
  88. 88.
    Yu JS, Yong WH, Wilson D, Black KL. Glioblastoma induction after radiosurgery for meningioma. Lancet. 2000;356:1576–7.CrossRefPubMedGoogle Scholar
  89. 89.
    Cahan W, Woodard H, Highinbotham N, Stewart F, Coley B. Sarcoma arising in irradiated bone: report of eleven cases. Cancer. 1948;1:3–29.CrossRefPubMedGoogle Scholar
  90. 90.
    Loeffler JS, Niemierko A, Chapman PH. Second tumors after radiosurgery: tip of the iceberg or a bump in the road? Neurosurgery. 2003;52:1436–40; discussion 1440–32.CrossRefPubMedGoogle Scholar
  91. 91.
    Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D. Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg. 2005;102 Suppl:195–9.Google Scholar
  92. 92.
    Muracciole X, Cowen D. Regis J: [Radiosurgery and brain radio-induced carcinogenesis: update]. Neurochirurgie. 2004;50:414–20.PubMedGoogle Scholar
  93. 93.
    Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after gamma knife stereotactic radiosurgery. Neurosurgery. 2007;60:60–5; discussion 65–6.PubMedGoogle Scholar
  94. 94.
    Ficker DM, So EL, Shen WK, Annegers JF, O’Brien PC, Cascino GD, Belau PG. Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology. 1998;51:1270–4.CrossRefPubMedGoogle Scholar
  95. 95.
    Sperling MR, Feldman H, Kinman J, Liporace JD, O’Connor MJ. Seizure control and mortality in epilepsy. Ann Neurol. 1999;46:45–50.CrossRefPubMedGoogle Scholar
  96. 96.
    Regis J, Arkha Y, Yomo S, Bartolomei F, Peragut JC. Chauvel P: [Radiosurgery for drug-resistant epilepsies: state of the art, results and perspectives]. Neurochirurgie. 2008;54:320–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jean Régis
    • 1
  • Romain Carron
    • 1
  • Fabrice Bartolomei
    • 2
  • Patrick Chauvel
    • 2
  1. 1.Department of Functional NeurosurgeryAix-Marseille University—Timone University HospitalMarseilleFrance
  2. 2.Department of NeurophysiologyAix-Marseille University—Timone University HospitalMarseilleFrance

Personalised recommendations