| Background I The epilepsy is a common nervous system diseases. It hasbeen reported there are at least 50,000,000 persons involved in epilepsy in the worlds. In China, the occurrence rate of epilepsy was about 4%o. In which, there were 20% cases, belonged to intractable epilepsy. This kind of patient need to be treated with neurosurgical managements. If the neurosurgical method was used for the patients with intractable epilepsy, the key point was the accuracy in localizing of epileptogenic foci. With the advances of medical science. MRS, CoEEG, dEEG, PET and MEG, etc, have been used for accurate localizing epileptogenic foci. In the areas of neurosurgery, stereotactic radiosurgery has been employed for intractable epilepsy due to the charateristics of minimally invasive and accurate lacalizing epileptogenic foci. In spite of extensive use of stereotactic radiosurgery for intractable epilepsy, the mechanisms about pathogenisis of epilepsy and radiosurgery have not been clear at present.Objective I The purpose of this study was as below:(1)By way of PET and MEG imagings, effects of gamma knife for intractable epilepsy were explored.(2)A sensorimotor cortex focal epilepsy model was induced by use ofsodium penicillin in rat brain surface. In oder to explore the mechanism of epilepsy. The expressions of c-fos, nNos and P53 were studied. And the changes of pathology in brain tissues were investigated in this experiment.(3)The rat epilepsy model was received the treatment with gamma knife. The mchanism on gamma knife radiosurgery was studied in our experiment.Part One Location of PET and MEG of epileptogenic foci and guiding gamma knife radiosurgery forintractable epilepsyMaterials and Methods: Altogether 33 patients with intractable epilepsy were treated by use of gamma knife, and 30 of them with follow-up data were analysed in this clinic trial. All those patients had a follow-up period of 6-19 months. There were 17 males and 13 females, with age of 8-53(average of 23.3 ?7.2). According to the criterion of International Epilepsy Association, 24 patients belonged to generalized seizures and 6 partial seizures. By way of vedio EEG examination, 26 patients showed the abnormal recordings. There were 12 patients with local slow waves, 10 patients with spike, sharp or spike-slow waves, and 4 patients with diffuse slow waves. 19 patients could determined the location of epilepsy with vedio EEG examination. The epilepogenic foci were determined with PET in 22 cases and with MEG in 8 cases. All patients, were treated by use of Leksell C-model gamma knife with 8-13Gy peripheral dose and with 16-45Gy target center dose. The effects of gamma knife treatment were valuated according to the EEG data pre-or post-radiosurgery with interval period of 3 months.The data of EEG and clinic outcome in epileptic controling between PET and MEG groups were compared periodically. The effcancy of radiosurgery with gamma knife were classified as grade I to VI with the standard of Internationd Epilepsy Association.Results: In 6-19 months of follow-up, the data showed that there were 10 cases(33.3%) with out seizure of epilepsy (grade I ~~ II), 14 cases (46.7%) with a little seizures of epilepsy (grade III ~ IV), 4 cases (13.3%) with seizures of epilepsy as pre-radiosurgic treatment (grade V ) and 2 cases (6.7%) with increasing of seizures of epilepsy((gradeVI). There was no complications, disability or mortality. In spite of the seizures no evidently alteration after immediate radio surgical treatment, a markedly decreasing of seizure was found after 3 months follow-up in the PET and MEG groups (P<0.01). According to EEG follow-up data, there were 12 cases (48.0%) with normal EEG recording, 9 cases (36.0%) with better EEG recording, 2 cases (8.0%) without change of EEG recording and 2 cases (8.0%) with more seizures of EEG recording than before radiosurgery. A significant decreasing of seizures on EEG recording was seen between before radisurgery and after 3 months follow-up. With PET and MEG loca...
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