Efficacy and safety of magnetic resonance-guided laser interstitial thermal therapy for drug resistant epilepsy_Journal of Epilepsy

Authors：

HU Wenhan , YAO Yuan , MO Jiajie , ZHANG Chao , WANG Xiu , LIU Chang , ZHAO Baotian ,  ZHANG Jianguo ,  ZHANG Kai

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;

Corresponding author：

ZHANG Jianguo, Email: zjguo73@126.com; ZHANG Kai, Email: zhangkai62035@foxmail.com

Keywords：

MRI-guided laser interstitial thermal therapy; Drug resistant epilepsy; Minimal invasive; Epilepsy surgery

DOI：

10.7507/2096-0247.202202003

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the effect of magnetic resonance-guided laser interstitial thermal therapy (Magnetic resonance-guided laser interstitial thermal therapy , MRgLITT) for drug resistant epilepsy (DRE). Methods The present study analyzed the clinical information of DRE patients treated by MRgLITT in Beijing Tiantan Hospital from August 2020 to February 2021, including the type of disease, postoperative complications, and prognosis (Engel classification) in the one year after surgery. Results A total of 55 patients were enrolled. There were 27 males and 28 females, with an average of (21.7±14.1) years, all of whom successfully completed the operation and were followed up for the 1 year after surgery. The diagnosis included intracranial tumors, hypothalamic hamartoma (HH), focal cortical dysplasia (FCD), cavernous malformations (CM), mesial temporal lobe epilepsy (mTLE), and idiopathic generalized epilepsy (underwent corpus callosotomy). The patients with seizure freedom accounted for 59.6% (31/52), and the average remission rate of palliative surgery was 68.6%. The short-term postoperative complications included bleeding in neurological deficit in 6 cases (10.9%), 4 cases (7.3%), and noninfectious fever in 2 cases (3.6%). No serious, long-term complications occurred. The average postoperative hospital stay was (4.7±1.6) days. Conclusions MRgLITT is gradually mature and has a wide range of indications. This technology provides a safe and effective therapy for DRE patients.

Citation： HU Wenhan, YAO Yuan, MO Jiajie, ZHANG Chao, WANG Xiu, LIU Chang, ZHAO Baotian, ZHANG Jianguo, ZHANG Kai. Efficacy and safety of magnetic resonance-guided laser interstitial thermal therapy for drug resistant epilepsy. Journal of Epilepsy, 2022, 8(3): 202-206. doi: 10.7507/2096-0247.202202003 Copy

1.	Engel J. The current place of epilepsy surgery. Current opinion in neurology, 2018, 31(2): 192-197.
2.	Engel J Jr, McDermott MP, Wiebe S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA, 2012, 307(9): 922-930.
3.	Bown S. Phototherapy in tumors. World Journal of Surgery, 1983, 7(6): 700-709.
4.	Sugiyama K, Sakai T, Fujishima I, et al. Stereotactic interstitial laser-hyperthermia using Nd-YAG laser. Stereotactic and Functional Neurosurgery, 1990, 54(1-8): 501-505.
5.	胡文瀚, 莫嘉杰, 刘畅, 等. 磁共振引导激光间质热疗治疗药物难治性癫痫的手术策略及疗效. 中华神经外科杂志, 2021, 37(8): 764-770.
6.	Rosenfeld JV, Feiz-Erfan I. Hypothalamic hamartoma treatment: surgical resection with the transcallosal approach. Semin Pediatr Neurol, 2007, 14(2): 88-98.
7.	Wait SD, Abla AA, Killory BD, et al. Surgical approaches to hypothalamic hamartomas. Neurosurg Focus, 2011, 30(2): e2.
8.	Wilfong AA, Curry DJ. Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis. Epilepsia, 2013, 54(Suppl 9): 109-114.
9.	Du VX, Gandhi SV, Rekate HL, et al. Laser interstitial thermal therapy: a first line treatment for seizures due to hypothalamic hamartoma? Epilepsia, 2017, 58(Suppl 2): 77-84.
10.	Youngerman BE, Save AV, McKhann GM. Magnetic resonance imaging-guided laser interstitial thermal therapy for epilepsy: systematic review of technique, indications, and outcomes. Neurosurgery, 2020, 86(4): e366-e382.
11.	Patel P, Patel NV, Danish SF. Intracranial MR-guided laser-induced thermal therapy: single-center experience with the visualase thermal therapy system. J Neurosurg, 2016, 125(4): 853-860.
12.	Shaker T, Bernier A, Carmant L. Focal cortical dysplasia in childhood epilepsy. Semin Pediatr Neurol, 2016, 23(2): 108-119.
13.	Battaglia G, Chiapparini L, Franceschetti S, et al. Periventricular nodular heterotopia: classification, epileptic history, and genesis of epileptic discharges. Epilepsia, 2006, 47(1): 86-97.
14.	LaRiviere MJ, Gross RE. Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery. Frontiers in Surgery, 2016, 3: 64.
15.	Waseem H, Osborn KE, Schoenberg MR, et al. Laser ablation therapy: An alternative treatment for medically resistant mesial temporal lobe epilepsy after age 50. Epilepsy Behav, 2015, 51: 152-157.
16.	Wu C, Jermakowicz WJ, Chakravorti S, et al. Effects of surgical targeting in laser interstitial thermal therapy for mesial temporal lobe epilepsy: a multicenter study of 234 patients. Epilepsia, 2019, 60(6): 1171-1183.
17.	Drane DL, Loring DW, Voets NL, et al. Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy. Epilepsia, 2015, 56(1): 101-113.
18.	Chang EF, Gabriel RA, Potts MB, et al. Supratentorial cavernous malformations in eloquent and deep locations: surgical approaches and outcomes. J Neurosurg, 2011, 114(3): 814-827.
19.	Steiger HJ, Markwalder TM, Reulen HJ. Clinicopathological relations of cerebral cavernous angiomas: observations in eleven cases. Neurosurgery, 1987, 21(6): 879-884.
20.	Awad I, Jabbour P. Cerebral cavernous malformations and epilepsy. Neurosurg Focus, 2006, 21(1): e7.
21.	Palma AE, Wicks RT, Popli G, et al. Corpus callosotomy via laser interstitial thermal therapy: a case series. J Neurosurg Pediatr, 2018, 23(3): 303-307.
22.	Asadi-Pooya AA, Sharan A, Nei M, et al. Corpus callosotomy. Epilepsy Behav, 2008, 13(2): 271-278.
23.	Palma AE, Wicks RT, Popli G, et al. Corpus callosotomy via laser interstitial thermal therapy: a case series. Journal of Neurosurgery:Pediatrics PED, 2019, 23(3): 303-307.

1. Engel J. The current place of epilepsy surgery. Current opinion in neurology, 2018, 31(2): 192-197.
2. Engel J Jr, McDermott MP, Wiebe S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA, 2012, 307(9): 922-930.
3. Bown S. Phototherapy in tumors. World Journal of Surgery, 1983, 7(6): 700-709.
4. Sugiyama K, Sakai T, Fujishima I, et al. Stereotactic interstitial laser-hyperthermia using Nd-YAG laser. Stereotactic and Functional Neurosurgery, 1990, 54(1-8): 501-505.
5. 胡文瀚, 莫嘉杰, 刘畅, 等. 磁共振引导激光间质热疗治疗药物难治性癫痫的手术策略及疗效. 中华神经外科杂志, 2021, 37(8): 764-770.
6. Rosenfeld JV, Feiz-Erfan I. Hypothalamic hamartoma treatment: surgical resection with the transcallosal approach. Semin Pediatr Neurol, 2007, 14(2): 88-98.
7. Wait SD, Abla AA, Killory BD, et al. Surgical approaches to hypothalamic hamartomas. Neurosurg Focus, 2011, 30(2): e2.
8. Wilfong AA, Curry DJ. Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis. Epilepsia, 2013, 54(Suppl 9): 109-114.
9. Du VX, Gandhi SV, Rekate HL, et al. Laser interstitial thermal therapy: a first line treatment for seizures due to hypothalamic hamartoma? Epilepsia, 2017, 58(Suppl 2): 77-84.
10. Youngerman BE, Save AV, McKhann GM. Magnetic resonance imaging-guided laser interstitial thermal therapy for epilepsy: systematic review of technique, indications, and outcomes. Neurosurgery, 2020, 86(4): e366-e382.
11. Patel P, Patel NV, Danish SF. Intracranial MR-guided laser-induced thermal therapy: single-center experience with the visualase thermal therapy system. J Neurosurg, 2016, 125(4): 853-860.
12. Shaker T, Bernier A, Carmant L. Focal cortical dysplasia in childhood epilepsy. Semin Pediatr Neurol, 2016, 23(2): 108-119.
13. Battaglia G, Chiapparini L, Franceschetti S, et al. Periventricular nodular heterotopia: classification, epileptic history, and genesis of epileptic discharges. Epilepsia, 2006, 47(1): 86-97.
14. LaRiviere MJ, Gross RE. Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery. Frontiers in Surgery, 2016, 3: 64.
15. Waseem H, Osborn KE, Schoenberg MR, et al. Laser ablation therapy: An alternative treatment for medically resistant mesial temporal lobe epilepsy after age 50. Epilepsy Behav, 2015, 51: 152-157.
16. Wu C, Jermakowicz WJ, Chakravorti S, et al. Effects of surgical targeting in laser interstitial thermal therapy for mesial temporal lobe epilepsy: a multicenter study of 234 patients. Epilepsia, 2019, 60(6): 1171-1183.
17. Drane DL, Loring DW, Voets NL, et al. Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy. Epilepsia, 2015, 56(1): 101-113.
18. Chang EF, Gabriel RA, Potts MB, et al. Supratentorial cavernous malformations in eloquent and deep locations: surgical approaches and outcomes. J Neurosurg, 2011, 114(3): 814-827.
19. Steiger HJ, Markwalder TM, Reulen HJ. Clinicopathological relations of cerebral cavernous angiomas: observations in eleven cases. Neurosurgery, 1987, 21(6): 879-884.
20. Awad I, Jabbour P. Cerebral cavernous malformations and epilepsy. Neurosurg Focus, 2006, 21(1): e7.
21. Palma AE, Wicks RT, Popli G, et al. Corpus callosotomy via laser interstitial thermal therapy: a case series. J Neurosurg Pediatr, 2018, 23(3): 303-307.
22. Asadi-Pooya AA, Sharan A, Nei M, et al. Corpus callosotomy. Epilepsy Behav, 2008, 13(2): 271-278.
23. Palma AE, Wicks RT, Popli G, et al. Corpus callosotomy via laser interstitial thermal therapy: a case series. Journal of Neurosurgery:Pediatrics PED, 2019, 23(3): 303-307.

Previous Article
国际专家组副肿瘤性神经综合征新诊断标准解读
Next Article
Analysis of clinical features of epilepsy comorbid with tic disorders in children

Journal of Epilepsy

Efficacy and safety of magnetic resonance-guided laser interstitial thermal therapy for drug resistant epilepsy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content