Stereotactic Radiosurgery for Treatment of Drug-Resistant Epilepsy: State of the Art and Emerging Applications

Radiosurgery is an emerging and interesting treatment option for several types of drug-resistant epilepsies. Particularly, CyberKnife radiosurgery may represent a therapeutic approach for mesial temporal lobe epilepsies, as well as epilepsies due to hypothalamic hamartomas and arteriovenous malformations. There are many reports in the literature, but precise patient selection, dosimetry, target volume, and expected shortand long-term outcomes are still under investigation. We provide an overview of current and emerging radiosurgical technology, to discuss the biological mechanisms and the clinical applications, and general results of radiosurgery for the treatment of drug-resistant epilepsies. Despite encouraging preliminary results, definitive evidence to support the role of radiosurgery in the treatment of drug-resistant epilepsy is missing and more prospective trials are needed to identify predictors for treatment success in the different types of medically intractable epilepsy. Categories: Pediatric Surgery, Neurology, Neurosurgery