The role of gamma knife surgery in the treatment of severe epilepsies

There is a strong rationale for investigation of the role of gamma knife ra diosurgery in the treatment of medically intractable epilepsy. To explore t his potential application, the current outcome and morbidity associated wit h established microsurgical treatment, as well as the associated advantages and disadvantages of open surgery, are reviewed. The preliminary evidence in support of radiosurgical treatment and the recent experience with gamma knife treatment, for epilepsy associated with mesial temporal sclerosis, ca vernous angioma, and hypothalamic hamartoma or other lesions are presented. The strengths and limitations of this application are discussed, and the c hallenges facing both microsurgical and radiosurgical approaches are consid ered. Gamma knife surgery can be a main approach among others in the armame ntarium of epilepsy surgery. Although the benefits of comfort and reduced i nvasivity can be clearly perceived, larger series and long-term follow up a re sti II required in order to evaluate the future of this particular surgi cal approach.