Epilepsy Procedure A First In Hoosier State
INDIANAPOLIS - Indiana University School of Medicine will treat the
first patient in Indiana with a new, non-invasive surgical procedure to
eliminate epileptic seizures on June 6.
The School of Medicine is one of six institutions in the nation participating
in the National Institutes of Health clinical trial for intractable epilepsy.
Currently, the only approved treatments involve medication or invasive
surgery. This protocol is called radiosurgery and uses the Gamma Knife
to focus 201 beams of gamma radiation on the precise location of the brain
responsible for the seizures.
When the beams converge, the targeted area of the brain receives a full-treatment
dose of radiation. Gamma Knife radiosurgery spares healthy areas of the
brain from high-dose exposure to gamma radiation.
“This is the first clinical trial in the United States of this promising
treatment for epilepsy,” says Paul DesRosiers, M.D., assistant professor
of radiation oncology and the principal investigator of the IU School
of Medicine trial. “As many as 10 patients will be treated at IU
in this trial which is designed to determine the most effective radiation
dose for eliminating the seizure focus in the brain.”
Patients over the age of 18 with a specific form of temporal lobe epilepsy,
who would otherwise be candidates for the traditional surgery, are eligible
to participate in this clinical trial. It is estimated that up to 1 percent
of the U.S. population has epilepsy and that 20 percent of those patients
have the type of epilepsy that may benefit from surgery. The surgery,
for patients with seizures stemming from one temporal lobe of the brain,
is up to 95 percent effective.
“The IU Comprehensive Epilepsy Program is the only one in the state
dealing with these extreme cases,” says Vicenta Salanova, M.D., associate
professor of neurology and co-director of the program. “More than
500 patients have been evaluated in the clinic and, of those, 300 have
qualified for surgery. As many as 90 percent of these patients became
seizure free or had rare seizures, with significant improvement in their
quality of life. Preliminary data indicate that the Gamma Knife radiosurgery
also may be effective for select patients and will offer them another
treatment option.”
Gamma Knife radiosurgery eliminates many of the risks inherent with traditional
surgery because it is non-invasive. The radiation is diffused through
a 300-pound collimator helmet, which resembles a large version of the
kitchen colander. The patient’s head is placed inside the helmet
and held fast at four points to the skull. Each of the “drain holes”
is actually an aperture that creates beams of varying strength and diameter
allowing precise delineation of the area to be treated. When the individual
beams converge, that area receives the full treatment dose of gamma radiation.
Treatment time is much less than that of traditional surgery and the recovery
period usually involves only one over-night hospital stay.
Faculty members from the IU Departments of Neurology, Neurosurgery, Neuroradiology
and Radiation Oncology are involved in the clinical trial. Patients are
initially evaluated in the multidisciplinary seizure disorder clinic by
Dr. Salanova and Robert M. Worth, M.D., professor of neurosurgery, co-directors
of the program.
Treatments will be done in the Indiana Lions Gamma Knife Center at the
Indiana Cancer Pavilion. The center is directed by Robert Timmerman, M.D.,
assistant professor of radiation oncology, and Thomas Witt, M.D., associate
professor of neurosurgery.
IU School of Medicine was the first in the state to use Gamma Knife radiosurgery
technology. The first patient in Indiana was treated in September 1997
and since then more than 500 patients with benign and malignant brain
tumors, vascular malformations or facial pain, such as trigeminal neuralgia,
have been treated with this sophisticated technology.
Recent advances in neuroradiology have made it possible to more precisely
evaluate the function of different regions of the brain leading to advanced
treatments such as radiosurgery for epilepsy.
For additional information about the trial, call 317- 274-1190.
For more information on the IU Gamma Knife program, see www.iupui.edu/~neurosur/GammaKnife.html
or www.clarian.org/clinical/gammaknife/index.jhtml?print=true.
# # #
Media Contact: Mary Hardin
317-274-7722
mhardin@iupui.edu
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