scholarly journals Optic Radiation Tractography and Visual Field Deficits in Laser Interstitial Thermal Therapy for Amygdalohippocampectomy in Patients with Mesial Temporal Lobe Epilepsy

2017 ◽  
Vol 95 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Dali Yin ◽  
John A. Thompson ◽  
Cornelia Drees ◽  
Steven G. Ojemann ◽  
Lidia Nagae ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Optic Radiation ◽  
Laser Interstitial Thermal Therapy ◽  
Visual Field Deficits ◽  
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

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

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.

scholarly journals Laser ablation for mesial temporal epilepsy: a multi-site, single institutional series

2019 ◽  
Vol 130 (6) ◽  
pp. 2055-2062 ◽  
Author(s):  
Sanjeet S. Grewal ◽  
Richard S. Zimmerman ◽  
Gregory Worrell ◽  
Benjamin H. Brinkmann ◽  
William O. Tatum ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Learning ◽  
Mesial Temporal Lobe Epilepsy ◽  
Ablation Volume ◽  
Significant Difference ◽  
Visual Field Deficits ◽  
Mesial Temporal Lobe

OBJECTIVEAlthough it is still early in its application, laser interstitial thermal therapy (LiTT) has increasingly been employed as a surgical option for patients with mesial temporal lobe epilepsy. This study aimed to describe mesial temporal lobe ablation volumes and seizure outcomes following LiTT across the Mayo Clinic’s 3 epilepsy surgery centers.METHODSThis was a multi-site, single-institution, retrospective review of seizure outcomes and ablation volumes following LiTT for medically intractable mesial temporal lobe epilepsy between October 2011 and October 2015. Pre-ablation and post-ablation follow-up volumes of the hippocampus were measured using FreeSurfer, and the volume of ablated tissue was also measured on intraoperative MRI using a supervised spline-based edge detection algorithm. To determine seizure outcomes, results were compared between those patients who were seizure free and those who continued to experience seizures.RESULTSThere were 23 patients who underwent mesial temporal LiTT within the study period. Fifteen patients (65%) had left-sided procedures. The median follow-up was 34 months (range 12–70 months). The mean ablation volume was 6888 mm3. Median hippocampal ablation was 65%, with a median amygdala ablation of 43%. At last follow-up, 11 (48%) of these patients were seizure free. There was no correlation between ablation volume and seizure freedom (p = 0.69). There was also no correlation between percent ablation of the amygdala (p = 0.28) or hippocampus (p = 0.82) and seizure outcomes. Twelve patients underwent formal testing with computational visual fields. Visual field changes were seen in 67% of patients who underwent testing. Comparing the 5 patients with clinically noticeable visual field deficits to the rest of the cohort showed no significant difference in ablation volume between those patients with visual field deficits and those without (p = 0.94). There were 11 patients with follow-up neuropsychological testing. Within this group, verbal learning retention was 76% in the patients with left-sided procedures and 89% in those with right-sided procedures.CONCLUSIONSIn this study, there was no significant correlation between the ablation volume after LiTT and seizure outcomes. Visual field deficits were common in formally tested patients, much as in patients treated with open temporal lobectomy. Further studies are required to determine the role of amygdalohippocampal ablation.

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