Laser Interstitial Thermal Therapy for Mesial Temporal Lobe Epilepsy

Abstract

ATLAH, anterior temporal lobectomy with amygdalohippocampectomyLITT, laser interstitial thermal therapyMRg-LITT, magnetic resonance-guided laser interstitial thermal therapyMTLE, mesial temporal lobe epilepsySAH, selective amygdalohippocampectomySLAH, stereotactic laser amygdalohippocampotomy.

Laser ablation for mesial temporal lobe epilepsy: Surgical and cognitive outcomes with and without mesial temporal sclerosis

“…These outcomes are roughly comparable to traditional amygdalo‐hippocampectomies and anterior temporal lobe resections, and are better than previously published MRIgLITT case series . Compared to traditional anterior temporal resections, where Engel I surgical outcomes at 2 years of follow‐up is obtained for about 67% of patients, the Engel I surgical outcome obtained after MRIgLITT has been viewed as inferior by about 10%‐20% . Further, analyzing patients with a diagnosis of MTS and the necessity of SEEG investigations for seizure‐onset zone identification revealed no statistically significant differences between the percentages of patients with Engel class I surgical outcomes (Figure B).…”

“…A Medtronic Visualase MRI‐guided Laser Ablation system was used to perform LITT. The basic principles of LITT, as well as the Visualase system have been described previously . The specifics of the surgical procedure have been detailed in prior publications .…”

Laser ablation is effective for temporal lobe epilepsy with and without mesial temporal sclerosis if hippocampal seizure onsets are localized by stereoelectroencephalography

“…11,26 During the ablation, fast spoiled gradient-recalled echo images were obtained at 4-s intervals per acquisition and imported continuously to the Visualase workstation for derivation of thermal phase maps and cumulative irreversible damage zone. After coagulating the dura and passing a stylet, the laser cooling catheter and fiber were inserted to the stereotactic target distance and secured with the anchor bolt cap.…”

“…1 For these patients, stereotactic laser amygdalohippocampotomy (SLAH) using magnetic resonanceguided laser interstitial therapy (MRgLITT) is emerging as an important surgical option. 11,12 SLAH also causes less damage to the lateral temporal neocortex, and preliminary reports suggest that it may have less negative impact on memory and language function. 7,8 However, SLAH is less invasive than open surgery with shorter inpatient length of stay and recovery time.…”

“…7,8 However, SLAH is less invasive than open surgery with shorter inpatient length of stay and recovery time. 5,11,12 Although MRgLITT is a promising approach to the treatment of MTLE, it is still a relatively new procedure. 11,12 SLAH also causes less damage to the lateral temporal neocortex, and preliminary reports suggest that it may have less negative impact on memory and language function.…”