Stereotactic laser ablation of epileptogenic periventricular nodular heterotopia

Esquenazi, Yoshua; Kalamangalam, Giridhar P.; Slater, J. D. H.; Knowlton, Robert C.; Friedman, Elliott; Morris, Saint Aaron; Shetty, Anil; Gowda, Ashok; Tandon, Nitin

doi:10.1016/j.eplepsyres.2014.01.009

Cited by 146 publications

(79 citation statements)

References 22 publications

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“…In 2012, Curry and his team at Texas Children's Hospital [12] first reported the feasibility and efficacy of MRI-guided LiTT in ablating epileptic lesions in 5 pediatric patients. Since then, laser has been used to ablate a variety of epileptogenic lesions, including periventricular nodular heterotopia [13], tuberous sclerosis [14], cortical dysplasia [12,14], insular encephalomalacia [15], hypothalamic hamartomas (HH), and MTLE [7,12,16,17]. Although the literature on outcomes is limited to a handful reports, MRguided LiTT is a promising treatment alternative to open resections in patients with MTLE and HH.…”

Section: Application and Efficacymentioning

confidence: 99%

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Kang

Sperling

2017

Neurotherapeutics

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Surgery is the most effective treatment for drug-resistant epilepsy. Long-term studies demonstrate that about 60% to 80% of patients become seizure-free after anterior temporal lobectomy and a majority of patients (about 95%) report significant seizure reduction after surgery. In the last few years, there has been significant advances in minimally invasive surgical techniques to treat drug-resistant epilepsy. These minimally invasive procedures have significant advantages over open surgery in that they produce less immediate discomfort and disability, while allowing for greater preservation of functional tissue. Laser interstitial thermal therapy (LiTT) is an example of such a procedure. Recent advances in imaging, surgical navigation, and real-time thermal monitoring have made LiTT safer and easier to implement, offering an effective and powerful neurosurgical tool for drug-resistant epilepsy. This article will review the technical considerations, uses, and potential future directions for LiTT in drugresistant epilepsy.

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Section: Application and Efficacymentioning

confidence: 99%

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Kang

Sperling

2017

Neurotherapeutics

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“…Engel I seizure freedom was achieved in three patients with limited follow-up ranging from 2 to 13 months. MRgLITT has also been reportedly used for treatment of various other conditions including periventricular nodular heterotopia (54,77), insular epileptic foci (55), glial neoplasms (85), brain metastases (86), and teratoma (87).…”

Section: Mri-guided Laser Interstitial Thermal Therapy (Mrglitt)mentioning

confidence: 99%

Emerging surgical therapies in the treatment of pediatric epilepsy

Karsy¹,

Guan²,

Ducis³

et al. 2016

Transl. Pediatr.

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Abstract:In the approximately 1% of children affected by epilepsy, pharmacoresistance and early age of seizure onset are strongly correlated with poor cognitive outcomes, depression, anxiety, developmental delay, and impaired activities of daily living. These children often require multiple surgical procedures, including invasive diagnostic procedures with intracranial electrodes to identify the seizure-onset zone. The recent development of minimally invasive surgical techniques, including stereotactic electroencephalography (SEEG) and MRI-guided laser interstitial thermal therapy (MRgLITT), and new applications of neurostimulation, such as responsive neurostimulation (RNS), are quickly changing the landscape of the surgical management of pediatric epilepsy. In this review, the authors discuss these various technologies, their current applications, and limitations in the treatment of pediatric drug-resistant epilepsy, as well as areas for future research. The development of minimally invasive diagnostic and ablative surgical techniques together with new paradigms in neurostimulation hold vast potential to improve the efficacy and reduce the morbidity of the surgical management of children with drug-resistant epilepsy.

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“…To date, studies report laser ablation of tuberous sclerosis, hypothalamic hamartoma, mesial temporal sclerosis, cortical dysplasia, and periventricular nodular hyperplasia with follow-up ranging from 2 to 13 months. [51][52][53][54] Seven of a total of 9 patients remained seizure-free at 6-to 13-month follow-up, depending on the study. The remaining 2 patients experienced seizure recurrence at 2 and 3 months after LITT and underwent subsequent definitive open surgical treatment.…”

Section: Epilepsymentioning

confidence: 99%

“…The remaining 2 patients experienced seizure recurrence at 2 and 3 months after LITT and underwent subsequent definitive open surgical treatment. 52,54 Figure 7 provides an imaging example of ablation of the left hippocampo-amygdalar area to treat mesial temporal sclerosis.…”

Section: Epilepsymentioning

confidence: 99%

Current Applications of MRI-Guided Laser Interstitial Thermal Therapy in the Treatment of Brain Neoplasms and Epilepsy: A Radiologic and Neurosurgical Overview

Medvid¹,

Ruiz²,

Komotar

et al. 2015

AJNR Am J Neuroradiol

174

125

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SUMMARY:Minimally invasive stereotactic tumor ablation is a viable option for the treatment of benign and malignant intracranial lesions. Although surgical excision constitutes first-line therapy for various brain pathologies, it can cause irreversible neurologic deficits. Additionally, many patients who may benefit from surgery do not qualify as surgical candidates due to multiple comorbidities. Recent advancements in laser interstitial thermal therapy, namely the ability to monitor ablation in real-time under MR imaging, have improved the safety and efficacy of the procedure. MRI-guided laser interstitial thermal therapy is currently used as a minimally invasive treatment for brain metastases, radiation necrosis, glioma, and epilepsy. This article will discuss the principles, suggested indications, complications, and imaging characteristics of MRI-guided laser interstitial thermal therapy as they pertain to the treatment of brain pathology. ABBREVIATIONS:GBM ϭ glioblastoma multiforme; LITT ϭ laser interstitial thermal therapy; MRgLITT ϭ MRI-guided laser interstitial thermal therapy; MRTI ϭ MRI thermal imaging; RN ϭ delayed radiation necrosis; SRS ϭ stereotactic radiosurgery

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Stereotactic laser ablation of epileptogenic periventricular nodular heterotopia

Cited by 146 publications

References 22 publications

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Emerging surgical therapies in the treatment of pediatric epilepsy

Current Applications of MRI-Guided Laser Interstitial Thermal Therapy in the Treatment of Brain Neoplasms and Epilepsy: A Radiologic and Neurosurgical Overview

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