MR-Guided Laser Interstitial Thermal Therapy for Medically Refractory Lesional Epilepsy in Pediatric Patients: Experience and Outcomes.

MedStar author(s):
Citation: Pediatric Neurosurgery. 53(5):322-329, 2018.PMID: 30110689Institution: MedStar Washington Hospital CenterDepartment: NeurosurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Drug Resistant Epilepsy/su [Surgery] | *Laser Therapy/mt [Methods] | *Magnetic Resonance Imaging, Interventional/mt [Methods] | *Robotic Surgical Procedures/mt [Methods] | Adolescent | Child | Child, Preschool | Drug Resistant Epilepsy/et [Etiology] | Female | Humans | Male | Neuronavigation/mt [Methods] | Retrospective Studies | Stereotaxic Techniques | Treatment Outcome | Young AdultYear: 2018ISSN:
  • 1016-2291
Name of journal: Pediatric neurosurgeryAbstract: CONCLUSION: This study contributes to the sparse literature in this field by demonstrating the high efficacy and low morbidity of MRgLITT as a minimally invasive method of ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.Copyright (c) 2018 S. Karger AG, Basel.INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay.METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed. Demographic and outcome data were compiled and analyzed.OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.RESULTS: Twelve pediatric patients with a total 18 lesions underwent MRgLITT procedures between December 2013 and September 2017. Mean age at surgery was 11.1 years. Surgical substrates included 4 hypothalamic hamartomas, 3 periventricular heterotopias, 2 deep focal cortical dysplasias, 2 tuberous sclerosis, and 1 mesial temporal sclerosis. Methods of stereotaxis used included Leksell frame, BrainLab VarioGuide, ROSA robot guidance, and ClearPoint navigation. Mean procedure length was 250 min, and mean length of stay was 1.3 days. After treatment, 8 patients were seizure free (Engel I, 66.7%), 2 patients demonstrated significant improvement (Engel II, 16.7%), and 2 patients showed worthwhile improvement (Engel III, 16.7%). One patient developed a left superior quadrantanopsia postoperatively. Mean follow-up duration was 10 months.All authors: Fayed I, Gaillard WD, Keating RF, Oluigbo CO, Sacino MFFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-08-23
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Journal Article MedStar Authors Catalog Article 30110689 Available 30110689

CONCLUSION: This study contributes to the sparse literature in this field by demonstrating the high efficacy and low morbidity of MRgLITT as a minimally invasive method of ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.

Copyright (c) 2018 S. Karger AG, Basel.

INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay.

METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed. Demographic and outcome data were compiled and analyzed.

OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.

RESULTS: Twelve pediatric patients with a total 18 lesions underwent MRgLITT procedures between December 2013 and September 2017. Mean age at surgery was 11.1 years. Surgical substrates included 4 hypothalamic hamartomas, 3 periventricular heterotopias, 2 deep focal cortical dysplasias, 2 tuberous sclerosis, and 1 mesial temporal sclerosis. Methods of stereotaxis used included Leksell frame, BrainLab VarioGuide, ROSA robot guidance, and ClearPoint navigation. Mean procedure length was 250 min, and mean length of stay was 1.3 days. After treatment, 8 patients were seizure free (Engel I, 66.7%), 2 patients demonstrated significant improvement (Engel II, 16.7%), and 2 patients showed worthwhile improvement (Engel III, 16.7%). One patient developed a left superior quadrantanopsia postoperatively. Mean follow-up duration was 10 months.

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