Non-resective approaches for medically intractable epilepsy
Andrea G. Scherer
Search for more papers by this authorNicholas M. Barbaro
Search for more papers by this authorAndrea G. Scherer
Search for more papers by this authorNicholas M. Barbaro
Search for more papers by this authorSimon Shorvon MA MB BChir MD FRCP
Professor in Clinical Neurology and Consultant Neurologist
UCL Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
Search for more papers by this authorEmilio Perucca MD PhD FRCP(Edin)
Professor of Medical Pharmacology and Director, Clinical Trial Center
Clinical Pharmacology Unit, Department of Internal Medicine and Therapeutics University of Pavia, C. Mondino National Neurological Institute Pavia, Italy
Search for more papers by this authorJerome Engel Jr. MD PhD
Jonathan Sinay Distinguished Professor of Neurology and Director UCLA Seizure Disorder Center
Neurobiology, and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
Search for more papers by this authorSummary
Radiosurgery is now being used as a treatment modality to open resective microsurgery for medically intractable epilepsy. At present, it is being used as a treatment modality for epilepsy associated with vascular malformations, gelastic epilepsy associated with hypothalamic hamartomas, cavernous malformations and mesial temporal lobe epilepsy associated with mesial temporal sclerosis. The two main types of radiosurgery are Gamma Knife and linear accelerator (LINAC). Gamma Knife uses numerous sources of radioactive cobalt to direct gamma radiation to the centre of a helmet in which the patient's head is inserted, with these beams of radiation converging in three dimensions to focus intense doses of radiation precisely on a small volume. LINAC functions similarly, except LINAC uses a different source of radiation produced by X-rays from the impact of accelerated electrons, and the gantry must move in space to change the delivery angle of this radiation.
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