La Radiocirugía como Alternativa de Tratamiento en la Epilepsia del Lóbulo Temporal Recidivante

Abstract

Background: The temporal lobe epilepsy has a poor pharmacological response in 40 % of the patients. The surgery is effective for free or reduction seizure activity. Unfortunately 20 % of the cases have a relapse in 5 years and the cause is an incomplete hippocampus resection. Radiosurgery produces necrosis and is effective in the treatment of the brain tumors, arteriovenous brain malformations and some functional disorders. Objective: Demonstrate that radiosurgery is an effective treatment for the temporal lobe epilepsy. Material and Methods: A clinical control assay with no random maneuver was made in 7 patients with new seizure activity after temporal lobe epilepsy surgery. They received radiosurgery (30 Gy) in the remnant hippocampus at the Hospital General de México, during 2002 – 2008. We evaluate the Engel stage, the number of seizures before and after the treatment and the side effects in the memory and language. The effects of the radiosurgery in the hippocampus were determinate with spectroscopy. The statistical analysis for the results included Student’s T, Friedman and paired T tests. Results: At two years after treatment, all the patients had an important reduction of the seizure activity and they passed from the Engel Stage IV to I-II (p<0.05). No important adverse effects were reported in memory and language status. The targeted hippocampus was eliminated by necrosis in all the treated cases (p<0.05). Conclusions: The radiosurgery is an effective treatment for the epilepsy lobe surgery after surgical treatment failure.