Stereotactic volumetric radiofrequency lesioning of intracranial structures for control of intractable seizures.
Computed tomography (CT) scans provide three-dimensional information about intracranial structures, which can be used to place stereotactically guided radiofrequency (RF) lesions and destroy a targeted volume of tissue. This technique was used for lesioning of the corpus callosum (CC) or the amygdala-hippocampus complex (AHC) in 9 patients with intractable seizures. The procedures were monitored by intraoperative CT scans. Lesions were made in the AHC in 7 patients and the CC in 2 patients. In addition, multiple subpial transection (MST) was performed in 6 patients. The longest follow-up is 29 months with a median of 19 months. Five patients (56%) are free of seizures, 3 patients (33%) have greater than 90% reduction in seizure activity and 1 patient (11%) has greater than 50% but at most 90% reduction in seizure activity. There were no complications except for temporary hemiparesis following MST in 1 patient. The results suggest that stereotactic volumetric RF lesioning of the AHC and the CC may be safe and effective in controlling intractable seizures.
Patil
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AA
University of Nebraska Medical Center, Omaha, USA.
Andrews
R
R
Torkelson
R
R
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D003337:Corpus Callosum / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000601:surgery*; D013238:Stereotaxic Techniques