Magnetic resonance–guided laser interstitial thermal therapy versus stereoelectroencephalography-guided radiofrequency thermocoagulation for drug-resistant epilepsy: A systematic review and meta-analysis

Wang, Yangshuo; Xu, Jinshan; Liu, Tinghong; Chen, Feng; Chen, Shuai; Xie, Zixing; Tie, Fang; Liang, Shuli

doi:10.1016/j.eplepsyres.2020.106397

Cited by 24 publications

(18 citation statements)

References 69 publications

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“…This is consistent with findings of prior meta-analyses for the application of LA, RFT, and GKRS in the surgical treatment of epilepsy. 40 One of the main disadvantages of GKRS is the long period between treatment and symptomatic improvement, 41 which may be an essential factor associated with HH epilepsy cases. All stereotactic radiosurgery studies analyzed here used GKRS; CyberKnife stereotactic radiosurgery may be an alternative option in HH surgery, 42 but sufficient data in the literature are lacking for the analysis of this alternative.…”

Section: Discussionmentioning

confidence: 99%

“…Stereo-electroencephalography-guided RFT is an emerging technique that gained popularity for its accurate epileptogenic zone localization. 40 Still, in most patients with HH, the localization of the epileptogenic zone is not a challenging task. Despite differences in the seizure freedom between the three groups, all showed a significant improvement rate.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Iranmehr

Ohadi

Chavoshi

et al. 2022

Neurosurgical Focus

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OBJECTIVE Hypothalamic hamartoma (HH) is a rare, nonmalignant, heterotopic developmental malformation that consists of a mixture of normal neurons and glial cells. Resection of HHs has been associated with high rates of mortality and morbidity. Therefore, minimally invasive ablation methods could be the best treatment option for HH. The most frequently used minimally invasive options for HH ablation are radiofrequency thermocoagulation (RFT), laser ablation (LA), and stereotactic radiosurgery. METHODS To investigate three minimally invasive procedures in the treatment of refractory seizures related to HH, the authors conducted a systematic search in March 2022 in the MEDLINE, Embase, Scopus, and Web of Science databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seizure freedom was the primary outcome of interest. The authors defined seizure freedom as Engel class I or International League Against Epilepsy class 1 or 2 or as the reported term “seizure freedom.” The secondary outcome was long-term complications reported in studies. Both random- and fixed-effects models were used to calculate the pooled proportion of seizure freedom and complication rate with 95% confidence intervals. A modified version of the Joanna Briggs Institute (JBI) Critical Appraisal to assess the risk of bias was used. RESULTS The authors included 15 studies with 422 patients (RFT, n = 190; LA, n = 171; and Gamma Knife Radiosurgery [GKRS], n = 61). Generally, the mean incidences of overall seizure freedom after minimally invasive procedures were 77% (95% CI 0.74–0.81) and 68% (95% CI 0.57–0.79) using fixed- and random-effects models, respectively. The mean incidence of overall seizure freedom after RFT was 69% (95% CI 0.63–0.75), and the mean incidences of overall seizure freedom after LA and GKRS were 87% (95% CI 0.82–0.92) and 44% (95% CI 0.32–0.57), respectively. The total complication rate with minimally invasive procedures was 13% (95% CI 0.01–0.26). The complication rate in each treatment was as follows: 5% (95% CI 0.0–0.12) for RFT, 20% (95% CI 0.0–0.47) for LA, and 22% (95% CI 0–0.65) for GKRS. Meta-regression analysis showed an association between older age and higher complication rates in the LA group. CONCLUSIONS In this meta-analysis, LA showed superiority in seizure freedom over the other two methods. The complication rate associated with RFT was less than those in the other two methods; however, this difference was not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Iranmehr

Ohadi

Chavoshi

et al. 2022

Neurosurgical Focus

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“…High‐density SEEG‐guided radio‐frequency thermocoagulation (SEEG‐RFTC) has been reported in these patients and presented more extensive ablation and 77.8% cases with seizure‐free at final follow‐up (≥1 year) 64 . However, this report was the single study on SEEG‐RFTC in patients with TSC‐related epilepsy in English literature (Table 3), and the long‐term seizure control after SEEG‐RFTC is still controversial 65,66 . MRI‐guided laser‐induced interstitial thermotherapy (MRg‐LITT) has been reported in one case with TSC‐related epilepsy in China, 67 but it is considered to be an alternative approach to resective surgery and patients reached 58% seizure freedom after MRg‐LITT 68–70 …”

Section: Surgical Treatmentmentioning

confidence: 92%

“…64 However, this report was the single study on SEEG-RFTC in patients with TSCrelated epilepsy in English literature (Table 3), and the long-term seizure control after SEEG-RFTC is still controversial. 65,66 MRI-guided laser-induced interstitial thermotherapy (MRg-LITT) has been reported in one case with TSC-related epilepsy in China, 67 but it is considered to be an alternative approach to resective surgery and patients reached 58% seizure freedom after MRg-LITT. [68][69][70]…”

Section: Ablationmentioning

confidence: 99%

Progress of clinical research studies on tuberous sclerosis complex‐related epilepsy in China

Liu

Chen

Zhai

et al. 2022

Acta Neuro Scandinavica

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Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous syndrome, with 75.6%–83.5% and 54.1% patients presenting with epilepsy and drug‐resistant epilepsy (DRE), respectively. Clinical studies on TSC, particularly surgical interventions, have achieved rapid and substantial progress. The TSC‐Task Force Committee of the China Association Against Epilepsy (CAAE‐TFTSC) was founded in 2012, and annual academic conferences on the surgical treatment of TSC‐related epilepsy have been held since 2013. ‘China experts' consensus on surgical treatment of TSC‐related epilepsy’ was published in 2019. This review focuses on surgical treatment, including resective surgery, neuromodulations, corpus callosotomy and mini‐invasive ablations, as well as studies on phenotype, genotype and anti‐seizure therapies of mammalian target of rapamycin inhibitor, vigabatrin and ketogenic diet in patients with TSC‐related DRE in China.

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“…In SEEG-RFTC cases, patients with periventricular nodular heterotopias obtained the highest rate of seizure reduction. The rate of complications of both procedures was low (<5%) ( 89 ). A recent study suggested RFTC could be used as a segue to secondary interventions and for heterotopias.…”

Section: Seeg For Treatment: Intraoperative Guidance Laser Ablation A...mentioning

confidence: 99%

Stereo-Encephalographic Presurgical Evaluation of Temporal Lobe Epilepsy: An Evolving Science

et al. 2022

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Drug-resistant epilepsy is present in nearly 30% of patients. Resection of the epileptogenic zone has been found to be the most effective in achieving seizure freedom. The study of temporal lobe epilepsy for surgical treatment is extensive and complex. It involves a multidisciplinary team in decision-making with initial non-invasive studies (Phase I), providing 70% of the required information to elaborate a hypothesis and treatment plans. Select cases present more complexity involving bilateral clinical or electrographic manifestations, have contradicting information, or may involve deeper structures as a part of the epileptogenic zone. These cases are discussed by a multidisciplinary team of experts with a hypothesis for invasive methods of study. Subdural electrodes were once the mainstay of invasive presurgical evaluation and in later years most Comprehensive Epilepsy Centers have shifted to intracranial recordings. The intracranial recording follows original concepts since its development by Bancaud and Talairach, but great advances have been made in the field. Stereo-electroencephalography is a growing field of study, treatment, and establishment of seizure pattern complexities. In this comprehensive review, we explore the indications, usefulness, discoveries in interictal and ictal findings, pitfalls, and advances in the science of presurgical stereo-encephalography for temporal lobe epilepsy.

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Magnetic resonance–guided laser interstitial thermal therapy versus stereoelectroencephalography-guided radiofrequency thermocoagulation for drug-resistant epilepsy: A systematic review and meta-analysis

Cited by 24 publications

References 69 publications

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Progress of clinical research studies on tuberous sclerosis complex‐related epilepsy in China

Stereo-Encephalographic Presurgical Evaluation of Temporal Lobe Epilepsy: An Evolving Science

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