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Gamma Knife Surgery, a Neuromodulation Therapy in Epilepsy Surgery!

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Advances in Epilepsy Surgery and Radiosurgery

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 84))

Summary

Introduction. The more classical approach for Epilepsy surgery is the removal of the epileptogenic zone (ZE). We present a critical review of information in favor of a possible non-destructive effect of radiosurgery in epilepsy surgery.

Material. Clinical material of patients with epilepsies related to a lesion in highly functional areas subjected to radiosurgery with relief of the seizures and no functional worsening is available. We applied direct treatment of the EZ with good efficacy in the absence of destructive aspects on the MR and no functional deterioration (eg hypothalamic hamartomas). Experimental studies have shown biochemical differential effect of radiosurgery on the striatum, glial cell elimination, stem cell migration toward the target area, sprouting,... Plasticity phenomenon are induced by radiosurgery when using non necrotizing dosemetry.

Discussion. There is clinical and experimental evidence of Gamma Knife capability to induce modulation in the neural system. Detailed mechanism of this modulation and dosemetric parameters enabling to induce such plasticity with no necrosis are still unknown. Subpial transection turning out actually to be quite disappointing, there is a specific rationale to test radiosurgery capability to treat EZ cortex while preserving the underlying function of this cortex when the functional risk for cortectomy is too high.

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Authors and Affiliations

  1. Service de Neurochirurgie Fonctionnelle et Stéréotaxique, C.H.U. La Timone, 264 rue Saint Pierre, Marseilles Cedex 05, 13385, France

    Dr. J. Régis & M. Hayashi

  2. Neurophysiology/Neuropsychology INSERM 9926, Timone Hospital, Marseilles, France

    Dr. J. Régis, F. Bartolomei & P. Chauvel

  3. Neurophysiology Department, Timone Hospital, Marseilles, France

    F. Bartolomei & P. Chauvel

  4. Neurosurgery Department, Tokyo Women’s Medical University, Tokyo, Japan

    M. Hayashi

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  1. Universitätsklinik für Neurochirurgie, Karl-Franzens Universität, Graz, Austria

    B. Sutter  & O. Schröttner  & 

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Régis, J., Bartolomei, F., Hayashi, M., Chauvel, P. (2002). Gamma Knife Surgery, a Neuromodulation Therapy in Epilepsy Surgery!. In: Sutter, B., Schröttner, O. (eds) Advances in Epilepsy Surgery and Radiosurgery. Acta Neurochirurgica Supplements, vol 84. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6117-3_4

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