Fractionated stereotactically guided radiotherapy of pharmacoresistant temporal lobe epilepsy.

PURPOSE: This prospective study evaluated the efficacy of fractionated stereotactically guided radiotherapy (SRT) as a treatment of pharmacoresistant temporal lobe epilepsy.

PATIENTS AND

METHODS

Inclusion criteria were patients aged between 17 and 65 years with unilateral temporal focus, without sufficient epilepsy control by antiepileptic drugs or neurosurgery. Two groups of 6 patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were change in seizure frequency, intensity, seizure length and neuropsychological parameters.

RESULTS

All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i.e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i.e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in 5 out of 11 patients and intensity of seizures in 7 out of 11 patients.

CONCLUSION

Radiotherapy was identified as a safe and effective treatment for pharmacoresistant epilepsy since a good reduction of seizure frequency during longer follow-up was observed. SRT means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery.