Abstract
Background: Laser interstitial thermal therapy (LITT) presents an important new minimally invasive tool in the management of drug-resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. The objective of this study was to evaluate the postsurgical seizure outcome following LITT after a minimum follow-up period of 2 years. Methods: Medical records of all patients who underwent LITT for MTE from 2013 to 2018 at our comprehensive epilepsy center under a single surgeon were retrospectively reviewed. Data related to demographics, presurgical evaluations, and seizure outcome were compared between seizure-free (SF) and non–seizure-free (NSF) patients. Results: In all, 26 patients were identified with at least 2 years of follow-up. Mean age was 43.8 years ± 11.6 years, and 46.2% were female. After a mean follow-up time of 42.9 months (range, 24.3–58.8 months), 61.5% (16/26) were free of disabling seizures, and 26.9% (7/26) had only rare disabling seizures. Whereas seizure-freedom rates between patients with and without mesial temporal sclerosis (MTS) were not statistically different (68% vs. 43%, P = 0.23), NSF patients without MTS had a shorter median time to first seizure than did NSF patients with MTS (0.55 month vs. 10 months, log-rank test P = 0.007). Postoperative complications occurred in 2 patients (7.7%), consisting of 1 permanent and 1 transient homonymous hemianopia. Conclusions: LITT appears to be a safe and effective initial surgical option for treatment-resistant MTE. Among patients who have seizures after treatment, those without MTS appear to have seizures earlier than those with MTS.
| Original language | English (US) |
|---|---|
| Journal | World neurosurgery |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Engel outcome
- Laser interstitial thermal therapy
- Magnetic resonance–guided laser interstitial thermal therapy
- Mesial temporal epilepsy
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
Magnetic Resonance–Guided Laser Interstitial Thermal Therapy for Mesial Temporal Epilepsy : A Case Series Analysis of Outcomes and Complications at 2-Year Follow-Up. / Cajigas, Iahn; Kanner, Andres M.; Ribot, Ramses; Casabella, Amanda M.; Mahavadi, Anil; Jermakowicz, Walter; Sur, Samir; Millan, Carlos; Saporta, Anita; Lowe, Merredith; Velez-Ruiz, Naymee; Rey, Gustavo; Ibrahim, George M.; Ivan, Michael E.; Jagid, Jonathan R.
In: World neurosurgery, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Magnetic Resonance–Guided Laser Interstitial Thermal Therapy for Mesial Temporal Epilepsy
T2 - A Case Series Analysis of Outcomes and Complications at 2-Year Follow-Up
AU - Cajigas, Iahn
AU - Kanner, Andres M.
AU - Ribot, Ramses
AU - Casabella, Amanda M.
AU - Mahavadi, Anil
AU - Jermakowicz, Walter
AU - Sur, Samir
AU - Millan, Carlos
AU - Saporta, Anita
AU - Lowe, Merredith
AU - Velez-Ruiz, Naymee
AU - Rey, Gustavo
AU - Ibrahim, George M.
AU - Ivan, Michael E.
AU - Jagid, Jonathan R.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Laser interstitial thermal therapy (LITT) presents an important new minimally invasive tool in the management of drug-resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. The objective of this study was to evaluate the postsurgical seizure outcome following LITT after a minimum follow-up period of 2 years. Methods: Medical records of all patients who underwent LITT for MTE from 2013 to 2018 at our comprehensive epilepsy center under a single surgeon were retrospectively reviewed. Data related to demographics, presurgical evaluations, and seizure outcome were compared between seizure-free (SF) and non–seizure-free (NSF) patients. Results: In all, 26 patients were identified with at least 2 years of follow-up. Mean age was 43.8 years ± 11.6 years, and 46.2% were female. After a mean follow-up time of 42.9 months (range, 24.3–58.8 months), 61.5% (16/26) were free of disabling seizures, and 26.9% (7/26) had only rare disabling seizures. Whereas seizure-freedom rates between patients with and without mesial temporal sclerosis (MTS) were not statistically different (68% vs. 43%, P = 0.23), NSF patients without MTS had a shorter median time to first seizure than did NSF patients with MTS (0.55 month vs. 10 months, log-rank test P = 0.007). Postoperative complications occurred in 2 patients (7.7%), consisting of 1 permanent and 1 transient homonymous hemianopia. Conclusions: LITT appears to be a safe and effective initial surgical option for treatment-resistant MTE. Among patients who have seizures after treatment, those without MTS appear to have seizures earlier than those with MTS.
AB - Background: Laser interstitial thermal therapy (LITT) presents an important new minimally invasive tool in the management of drug-resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. The objective of this study was to evaluate the postsurgical seizure outcome following LITT after a minimum follow-up period of 2 years. Methods: Medical records of all patients who underwent LITT for MTE from 2013 to 2018 at our comprehensive epilepsy center under a single surgeon were retrospectively reviewed. Data related to demographics, presurgical evaluations, and seizure outcome were compared between seizure-free (SF) and non–seizure-free (NSF) patients. Results: In all, 26 patients were identified with at least 2 years of follow-up. Mean age was 43.8 years ± 11.6 years, and 46.2% were female. After a mean follow-up time of 42.9 months (range, 24.3–58.8 months), 61.5% (16/26) were free of disabling seizures, and 26.9% (7/26) had only rare disabling seizures. Whereas seizure-freedom rates between patients with and without mesial temporal sclerosis (MTS) were not statistically different (68% vs. 43%, P = 0.23), NSF patients without MTS had a shorter median time to first seizure than did NSF patients with MTS (0.55 month vs. 10 months, log-rank test P = 0.007). Postoperative complications occurred in 2 patients (7.7%), consisting of 1 permanent and 1 transient homonymous hemianopia. Conclusions: LITT appears to be a safe and effective initial surgical option for treatment-resistant MTE. Among patients who have seizures after treatment, those without MTS appear to have seizures earlier than those with MTS.
KW - Engel outcome
KW - Laser interstitial thermal therapy
KW - Magnetic resonance–guided laser interstitial thermal therapy
KW - Mesial temporal epilepsy
UR - http://www.scopus.com/inward/record.url?scp=85063937222&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063937222&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2019.03.057
DO - 10.1016/j.wneu.2019.03.057
M3 - Article
C2 - 30880205
AN - SCOPUS:85063937222
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -