Stereotactic laser interstitial thermal therapy corpus callosotomy for the treatment of pediatric drug‐resistant epilepsy

Mallela, Arka N.; Hect, Jasmine L; Abou‐Al‐Shaar, Hussam; Akwayena, Emefa; Abel, Taylor J.

doi:10.1002/epi4.12559

Cited by 16 publications

(19 citation statements)

References 28 publications

(51 reference statements)

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“…[41][42][43] This has previously been labeled as almost identical to SMA syndrome with uncertainty in its etiological relationship to corpus callosotomy as either a disconnection syndrome or a complication of an open interhemispheric approach. 26,33 One patient in this series experienced transient left hemiparesis, and there are 3 other reports of patients who also experienced this complication after laser callosotomy. 20,27,44 This suggests that this phenomenon is a true disconnection syndrome because there was no exposure or manipulation of the SMA in these cases.…”

Section: Observationsmentioning

confidence: 76%

“…Other temporary neurological deficits were reported in the literature, including truncal ataxia and imbalance, whereas 1 patient experienced permanent dysarthria after complete LITT callosotomy. 26–28 Five patients experienced intraparenchymal hemorrhage associated with LITT for corpus callosotomy. 20 , 27 , 44 , 45 …”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20][21][22][23][24] There are few reports of complete corpus callosotomy using LITT as a standalone procedure. [25][26][27][28] This study aimed to further demonstrate the efficacy and safety of complete corpus callosotomy using LITT and is the first to include multiple complete callosotomies with normal callosal anatomy, detailed technical description, follow-up beyond 1 year, and a quantitative assessment of the extent of ablation based on delayed imaging.…”

Section: Discussionmentioning

confidence: 99%

“…17 Additional reports on using LITT for corpus callosotomy provide insight into efficacy and outcomes of the technique. [25][26][27][28] Although there is growing evidence regarding the safety and efficacy of LITT for anterior two-thirds corpus callosotomy and completion callosotomy, there is a paucity of literature detailing complete callosotomies performed with LITT in patients with anatomically normal corpa callosa (CCs). Here, we present 3 cases of complete MRI-guided LITT corpus callosotomy with details on surgical strategy, quantitative assessment of completeness of the callosotomy using delayed imaging, and >1-year clinical outcomes.…”

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confidence: 99%

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Magnetic resonance imaging–guided laser interstitial thermal therapy for complete corpus callosotomy: technique and 1-year outcomes. Patient series

Best

Kim

Lew

2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Magnetic resonance imaging (MRI)-guided stereotactic laser interstitial thermal therapy (LITT) is a minimally invasive technique that has been described for the treatment of certain forms of epilepsy through partial or complete callosotomy, with few cases describing single-stage complete LITT callosotomy. The authors aimed to demonstrate this technique’s feasibility and efficacy through description of the technique and 1-year outcomes in 3 cases of single-stage complete LITT callosotomy in patients with anatomically normal corpa callosa (CCs). OBSERVATIONS The patients were aged 14–27 years and experienced atonic seizures. Completeness of callosotomy was determined from MRI scans obtained >3 months after LITT procedures. The estimated ablations of the CC were 94%, 89%, and 100%, respectively. The second patient had a catheter breach the lateral ventricle, resulting in the lowest estimated percentage of ablation in this series (89%), with minimal atonic seizure reduction. The first patient had significant reduction in atonic seizure frequency, and the third patient had complete resolution of atonic seizures. None of the patients experienced any long-term complications. Intensive care length of stay was 1 night for each patient, and total length of stay was between 2 and 7 nights. Postoperative follow-up was between 14 and 18 months. LESSONS Complete laser callosotomy is achievable and is a safe alternative to microsurgical or endoscopic approaches.

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Section: Observationsmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Magnetic resonance imaging–guided laser interstitial thermal therapy for complete corpus callosotomy: technique and 1-year outcomes. Patient series

Best

Kim

Lew

2022

Journal of Neurosurgery: Case Lessons

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“…Stereotactic electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) has been used for patients whose epileptic foci are not eligible for resection [ 8 , 9 ]. However, the only real-time imaging system to monitor ablation is laser interstitial thermal therapy (LiTT) [ 10 , 11 ], which is not available in East Asia.…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Radiofrequency Ablation Combined with Thermodynamic Simulation for Epilepsy Reoperations

Wang

Cheng

Hung

et al. 2022

JCM

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Repeat craniotomies to treat recurrent seizures may be difficult, and minimally invasive radiofrequency ablation is an alternative therapy. On the basis of this procedure, we aimed to develop a more reliable methodology which is helpful for institutions where real-time image monitoring or electrophysiologic guidance during ablation are not available. We used simulation combined with a robot-assisted radiofrequency ablation (S-RARFA) protocol to plan and execute brain epileptic tissue lesioning. Trajectories of electrodes were planned on the robot system, and time-dependent thermodynamics was simulated with radiofrequency parameters. Thermal gradient and margin were displayed on a computer to calculate ablation volume with a mathematic equation. Actual volume was measured on images after the ablation. This small series included one pediatric and two adult patients. The remnant hippocampus, corpus callosum, and irritative zone around arteriovenous malformation nidus were all treated with S-RARFA. The mean error percentage of the volume ablated between preoperative simulation and postoperative measurement was 2.4 ± 0.7%. No complications or newly developed neurologic deficits presented postoperatively, and the patients had little postoperative pain and short hospital stays. In this pilot study, we preliminarily verified the feasibility and safety of this novel protocol. As an alternative to traditional surgeries or real-time monitoring, S-RARFA served as successful seizure reoperation with high accuracy, minimal collateral damage, and good seizure control.

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