Radionecrosis following gamma knife treatment for mesial temporal lobe epilepsy

Abstract

A 24-year-old male patient was treated with Gamma Knife surgery (GKS) for medial temporal lobe epilepsy. The treatment parameters were in accordance with established practice. Epilepsy stopped after 2 years and medication was discontinued. Four years later, he developed a profound radionecrosis leading to blindness. As had refused surgical intervention his blindness has become permanent. As this is the second such case to be reported, it is considered a cause for concern, since microsurgery remains a safe alternative treatment. It is suggested that GKS for mesial temporal lobe epilepsy should be restricted to University centres of excellence as part of research projects under the control of ethics committees. It should not at present be considered to be a safe treatment for general use.

Key words:

• Radiosensitivity
• delayed radionecrosis
• temporal lobe epilepsy
• radiosurgery
• gamma knife
• functional

Acknowledgement

The authors would like to acknowledge the assistance of Dr. Ahmed Gaber who referred the patient and who managed his epilepsy.

Declaration of interest:

Dr. Ganz is a consultant for Elekta, Stockholm, the manufacturer of the Gamma Knife. Dr. Reda has no personal financial or institutional interest in any of the drugs, materials, or devices described in this article.