scholarly journals Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy

Epilepsia ◽  
2015 ◽  
Vol 57 (2) ◽  
pp. 325-334 ◽  
Author(s):  
Joon Y. Kang ◽  
Chengyuan Wu ◽  
Joseph Tracy ◽  
Matthew Lorenzo ◽  
James Evans ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
Mesial Temporal Lobe

scholarly journals Automated trajectory planning for laser interstitial thermal therapy in mesial temporal lobe epilepsy

Epilepsia ◽  
2018 ◽  
Vol 59 (4) ◽  
pp. 814-824 ◽  
Author(s):  
Vejay N. Vakharia ◽  
Rachel Sparks ◽  
Kuo Li ◽  
Aidan G. O'Keeffe ◽  
Anna Miserocchi ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Trajectory Planning ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
Mesial Temporal Lobe

Stereotactic EEG-guided laser interstitial thermal therapy for mesial temporal lobe epilepsy

2017 ◽  
Vol 89 (5) ◽  
pp. 542-548 ◽  
Author(s):  
James X Tao ◽  
Shasha Wu ◽  
Maureen Lacy ◽  
Sandra Rose ◽  
Naoum P Issa ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Temporal Lobectomy ◽  
Laser Interstitial Thermal Therapy ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
Mri Guided

ObjectiveTo determine the outcomes of combined stereo-electroencephalography-guided and MRI-guided stereotactic laser interstitial thermal therapy (LITT) in the treatment of patients with drug-resistant mesial temporal lobe epilepsy (mTLE).MethodsWe prospectively assessed the surgical and neuropsychological outcomes in 21 patients with medically refractory mTLE who underwent LITT at the University of Chicago Medical Center. We further compared the surgical outcomes in patients with and without mesial temporal sclerosis (MTS).ResultsOf the 21 patients, 19 (90%) underwent Invasive EEG study and 11 (52%) achieved freedom from disabling seizures with a mean duration of postoperative follow-up of 24±11 months after LITT. Eight (73%) of 11 patients with MTS achieved freedom from disabling seizures, whereas 3 (30 %) of 10 patients without MTS achieved freedom from disabling seizures. Patients with MTS were significantly more likely to become seizure-free, as compared with those without MTS (P=0.002). There was no significant difference in total ablation volume and the percentage of the ablated amygdalohippocampal complex between seizure-free and non-seizure-free patients. Presurgical and postsurgical neuropsychological assessments were obtained in 10 of 21 patients. While there was no group decline in any neuropsychological assessment, a significant postoperative decline in verbal memory and confrontational naming was observed in individual patients.ConclusionsMRI-guided LITT is a safe and effective alternative to selective amygdalohippocampectomy and anterior temporal lobectomy for mTLE with MTS. Nevertheless, its efficacy in those without MTS seems modest. Large multicentre and prospective studies are warranted to further determine the efficacy and safety of LITT.

scholarly journals Laser Interstitial Thermal Therapy for Mesial Temporal Lobe Epilepsy

Neurosurgery ◽  
2016 ◽  
Vol 79 (suppl_1) ◽  
pp. S83-S91 ◽  
Author(s):  
Robert T. Wicks ◽  
Walter J. Jermakowicz ◽  
Jonathan R. Jagid ◽  
Daniel E. Couture ◽  
Jon T. Willie ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Cost Benefit ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Temporal Lobectomy ◽  
Laser Interstitial Thermal Therapy ◽  
Selective Amygdalohippocampectomy ◽  
Mesial Temporal Lobe ◽  
Patients With Epilepsy

Abstract Approximately one-third of patients with epilepsy do not achieve adequate seizure control through medical management alone. Mesial temporal lobe epilepsy (MTLE) is one of the most common forms of medically refractory epilepsy referred for surgical management. Stereotactic laser amygdalohippocampotomy using magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is an important emerging therapy for MTLE. Initial published reports support MRg-LITT as a less invasive surgical option with a shorter hospital stay and fewer neurocognitive side effects compared with craniotomy for anterior temporal lobectomy with amygdalohippocampectomy and selective amygdalohippocampectomy. We provide a historical overview of laser interstitial thermal therapy development and the technological advancements that led to the currently available commercial systems. Current applications of MRg-LITT for MTLE, reported outcomes, and technical issues of the surgical procedure are reviewed. Although initial reports indicate that stereotactic laser amygdalohippocampotomy may be a safe and effective therapy for medically refractory MTLE, further research is required to establish its long-term effectiveness and its cost/benefit profile.

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