{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:47:22Z","timestamp":1783774042479,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T00:00:00Z","timestamp":1368144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NINDS, National Institute of Neurological Disorders and Stroke","award":["R01 NS39280-03"],"award-info":[{"award-number":["R01 NS39280-03"]}]},{"name":"Elekta AB"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,8]]},"abstract":"Summary<\/jats:title>Purpose<\/jats:title>Gamma knife radiosurgery (RS<\/jats:styled-content>) may be an alternative to open surgery for mesial temporal lobe epilepsy (MTLE<\/jats:styled-content>), but morbidities and the anticonvulsant mechanisms of RS<\/jats:styled-content> are unclear. Examination of visual field defects (VFDs<\/jats:styled-content>) after RS<\/jats:styled-content> may provide evidence of the extent of a postoperative fixed lesion. VFDs<\/jats:styled-content> occur in 52\u2013100% of patients following open surgery for MTLE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>This multicenter prospective trial of RS<\/jats:styled-content> enrolled patients with unilateral hippocampal sclerosis and concordant video\u2013electroencephalography (EEG<\/jats:styled-content>) findings. Patients were randomized to low (20\u00a0Gy) or high (24\u00a0Gy) doses delivered to the amygdala, hippocampal head, and parahippocampal gyrus. Postoperative perimetry were obtained at 24\u00a0months after RS<\/jats:styled-content>. Visual field defect ratios (VFDRs<\/jats:styled-content>) were calculated to quantify the degree of VFDs<\/jats:styled-content>. Results were contrasted with age, RS<\/jats:styled-content> dose and 50% isodose volume, peak volume of radiation\u2010induced change at the surgical target, quality of life measurements, and seizure remission.<\/jats:p><\/jats:sec>Key Findings<\/jats:title>No patients reported visual changes and no patients had abnormal bedside visual field examinations. Fifteen (62.5%) of 24 patients had postoperative VFDs<\/jats:styled-content>, all homonymous superior quadrantanopsias. None of the VFD<\/jats:styled-content>s were consistent with injury to the optic nerve or chiasm. Clinical diagnosis of VFD<\/jats:styled-content>s correlated significantly with VFDRs<\/jats:styled-content> (p\u00a0=\u00a00.0005). Patients with seizure remission had smaller (more severe) VFDRs<\/jats:styled-content> (p\u00a0=\u00a00.04). No other variables had significant correlations.<\/jats:p><\/jats:sec>Significance<\/jats:title>VFD<\/jats:styled-content>s appeared after RS<\/jats:styled-content> in proportions similar to historical comparisons from open surgery for MTLE<\/jats:styled-content>. The nature of VFD<\/jats:styled-content>s was consistent with lesions of the optic radiations. The findings support the hypothesis that the mechanism of RS<\/jats:styled-content> involves some degree of tissue damage and is not confined entirely to functional changes in neuromodulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12215","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T15:19:11Z","timestamp":1368199151000},"page":"1376-1380","source":"Crossref","is-referenced-by-count":23,"title":["Visual field defects after radiosurgery for mesial temporal lobe epilepsy"],"prefix":"10.1111","volume":"54","author":[{"given":"Holly","family":"Hensley\u2010Judge","sequence":"first","affiliation":[{"name":"Department of Neurology University of Virginia Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Quigg","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Virginia Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Barbaro","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Indiana University Indianapolis Indiana U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Virginia Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California San Francisco San Francisco California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California San Francisco San Francisco California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna K.","family":"Broshek","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurobehavioral Sciences University of Virginia Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen R.","family":"Lamborn","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California San Francisco San Francisco California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth D.","family":"Laxer","sequence":"additional","affiliation":[{"name":"Pacific Epilepsy Program California Pacific Medical Center San Francisco California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California San Francisco San Francisco California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne N.","family":"Heck","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Southern California Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Langone Medical Center New York University New York New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Beach","sequence":"additional","affiliation":[{"name":"Upstate Medical Center State University of New York Syracuse New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicenta","family":"Salanova","sequence":"additional","affiliation":[{"name":"Department of Neurology Indiana University Indianapolis Indiana U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Goodman","sequence":"additional","affiliation":[{"name":"Beth Israel Medical Center St. Lukes and Roosevelt Hospitals New York New York 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