Q: Do you know if the gamma knife has an application as a non-invasive surgical tool in the treatment of epilepsy? If so, would non-invasive surgery be a reasonable alternative for a larger group of seizure victims, including those who are controlled by medication but suffer side effects?
A: The gamma knife is an instrument that focuses radiation to a small point in the brain. It has been used to remove brain tumors that are too deep or precarious to access directly by surgery. While I have no personal experience with this, my colleagues have referred patients with seizures caused by inaccessable tumors, and have had good results. This procedure may not be as useful for the majority of epilepsies that do not have an associated tumor, and there are always concerns about long term effects of radiation. It is therefore likely that the majority of epilepsy surgery will still be performed in a conventional fashion.