Corpus callosotomy with gamma knife radiosurgery for a case of intractable generalised epilepsy

Bodaghabadi, Mohammad; Bitaraf, Mohammad Ali; Aran, Shima; Alikhani, Mazdak; Ashrafian, Hossein; Zahiri, Alireza; Alahverdi, M

doi:10.1684/epd.2011.0436

Cited by 27 publications

(18 citation statements)

References 39 publications

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“…The VNS works by decreasing the general susceptibility of the cortex to epilepsy [5, 9-10]. However, current data confirms the overall superiority of surgical corpus callosotomy to VNS for seizure control [1, 3, 5, 9-10]. …”

Section: Discussionmentioning

confidence: 72%

“…Some reports describe the uses of radiosurgery to perform a partial or total callosotomy [5-6, 12]. Although the preliminary results of this minimally invasive technique are encouraging, a long latency of the effects limits the practicality in patients with severely debilitating seizures [2, 5-6, 12].…”

Section: Discussionmentioning

confidence: 99%

“…Although the preliminary results of this minimally invasive technique are encouraging, a long latency of the effects limits the practicality in patients with severely debilitating seizures [2, 5-6, 12]. Further assessment and patient follow-up is also necessary to confirm long term results.…”

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Robotic Laser Corpus Callosotomy: A Proof of Concept

Singh

Essayed

Deb

et al. 2017

Cureus

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IntroductionWe describe the feasibility of using minimally invasive robotic laser interstitial thermotherapy (LITT) for achieving an anterior two-thirds as well as a complete corpus callosotomy.MethodsTen probe trajectories were plotted on normal magentic resonance imaging (MRI) scans using the Brainlab Stereotactic Planning Software (Brainlab, Munich, Germany). The NeuroBlate® System (Monteris Medical, MN, USA) was used to conform the thermal burn to the corpus callosum along the trajectory of the probe. The distance of the ideal entry site from either the coronal suture and the torcula or nasion and the midline was calculated. The distance of the probe tip from the dorsal and ventral limits of the callosotomy in the sagittal plane were also calculated.ResultsAnterior two-thirds callosotomy was possible in all patients using a posterior parieto-occipital paramedian trajectory through the non-dominant lobe. The average entry point was 3.64 cm from the midline, 10.6 cm behind the coronal suture, and 9.2 cm above the torcula. The probe tip was an average of 1.4 cm from the anterior commissure. For a total callosotomy, an additional contralaterally placed frontal probe was used to target the posterior one-third of the corpus callosum. The average entry site was 3.3 cm from the midline and 9.1 cm above the nasion. The average distance of the probe tip from the base of the splenium was 0.94 cm.ConclusionThe directional thermoablation capability of the NeuroBlate® system allows for targeted lesioning of the corpus callosum, to achieve a two-thirds or complete corpus callosotomy. A laser distance of < 2 cm is sufficient to reach the entire corpus callosum through one trajectory for an anterior two-thirds callosotomy and two trajectories for a complete callosotomy.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Robotic Laser Corpus Callosotomy: A Proof of Concept

Singh

Essayed

Deb

et al. 2017

Cureus

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“…Traditionally, callosotomy is performed as an open surgery with all the associated risks. Another approach to lesioning callosum is stereotactic radiosurgery [12] , [13] , [14] , [15] , [16] . Radiosurgery has been employed specifically to ablate the posterior callosum [17] .…”

Section: Discussionmentioning

confidence: 99%

Stereotactic laser ablation of the splenium for intractable epilepsy

Miller

Cartmell

et al. 2016

Epilepsy & Behavior Case Reports

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Partial or complete corpus callosotomies have been applied, traditionally via open surgical or radiosurgical approaches, for the treatment of epilepsy in patients with multifocal tonic, atonic, or myoclonic seizures. Minimally invasive methods, such as MRI-guided laser interstitial thermal ablation (MTLA), are being employed to functionally remove or ablate seizure foci in the treatment of epilepsy. This therapy can achieve effectiveness similar to that of traditional resection, but with reduced morbidity compared with open surgery. Here, we present a patient with a history of prior partial corpus callosotomy who continued to suffer from medically refractory epilepsy with bisynchronous onset. We report on the utilization of laser ablation of the splenium in this patient to achieve full corpus callosotomy. Adequate ablation of the splenial remnant was confirmed by postoperative MRI imaging, and at four-month follow-up, the patient's seizure frequency had dropped more than 50%. This is the first reported instance of laser ablation of the splenium to achieve full corpus callosotomy following a previous unsuccessful anterior callosotomy in a patient with intractable generalized epilepsy.

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“…SRS has also been used as a disconnection technique in the treatment of generalised epilepsy by corpus callosotomy 17. Current interest is centred mainly on the treatment of HHs and HS.…”

Section: Neuroablationmentioning

confidence: 99%

Advances in epilepsy surgery

Nowell

Miserocchi

McEvoy

et al. 2014

Journal of Neurology, Neurosurgery & Psychiatry

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This review summarises exciting recent and forthcoming advances that will impact on the surgical management of epilepsy in the near future. This does not cover the current accepted diagnostic methodologies or surgical treatments that are routinely practiced today. The content of this review was derived from a PubMed literature search, using the key words ‘Epilepsy Surgery’, ‘Neuromodulation’, ‘Neuroablation’, ‘Advances’, between 2010 and November 2013.

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Corpus callosotomy with gamma knife radiosurgery for a case of intractable generalised epilepsy

Cited by 27 publications

References 39 publications

Minimally Invasive Robotic Laser Corpus Callosotomy: A Proof of Concept

Minimally Invasive Robotic Laser Corpus Callosotomy: A Proof of Concept

Stereotactic laser ablation of the splenium for intractable epilepsy

Advances in epilepsy surgery

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