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• W125383485 abstract "OBJECTIVE: To describe experience with a novel, minimally invasive surgical technique for refractory mesial temporal lobe epilepsy. BACKGROUND: Traditional open surgical techniques are effective for treating refractory mesial temporal lobe epilepsy (MTLE), but can be associated with cognitive deficits. Previous minimally invasive alternatives such as radiofrequency ablation lack real-time determination of lesion location and volume. We describe our experience using stereotactic laser induced thermal therapy with real-time thermal imaging in patients with intractable MTLE. DESIGN/METHODS: The study includes 9 procedures in 8 adult patients with refractory MTLE, half with mesial temporal sclerosis (MTS). The procedure consists of stereotactic insertion, under general anesthesia, of an optical fiber targeting anterior hippocampus and terminating in the amygdala. Laser-induced thermal energy is delivered during continuous MR imaging. Temperature-sensitive images with estimates of thermal damage are displayed in real-time. The first 2 patients (examined retrospectively) had lesions limited to the parahippocampal gyrus. The next 6 procedures (followed prospectively) had successful initial SLTAH. One of the initial 2 patients underwent subsequent successful repeat SLTAH. RESULTS: In the first 2 patients, both without MTS, ablations limited to the parahippocampal gyrus did not yield seizure-freedom. The subsequent 7 procedures (prospective) produced successful anterior amygdalohippocampotomies. Of the 4 with MTS, 3 [M1] were Engel class I (free of disabling seizures), and the 4 th was Engel class II (rare disabling seizures) at 6 months. Of the 3 patients without MTS, 2 were Engel class II, and the 3 rd was Engel class IV (unchanged) at 6 months. The patient who underwent a redo SLTAH had unexpected homonymous hemianopsia. CONCLUSIONS: SLTAH is a feasible surgical technique for refractory MTLE. Preliminary results indicate seizure outcomes might differ in patients with and without MTS. The safety and efficacy of SLTAH needs to be evaluated with larger cohorts over time. Disclosure: Dr. Korb has nothing to disclose. Dr. Willie has nothing to disclose. Dr. Laxpati has nothing to disclose. Dr. Saindane has nothing to disclose. Dr. Nour has nothing to disclose. Dr. Gowda has received personal compensation for activities with Visualase and BioTex, Inc. Dr. Gowda has received compensation for serving as the director of Visualase and BioTex, Inc. Dr. Gowda holds stock and/or stock options in Visualase, which sponsored research in which Dr. Gowda was involved as an investigator. Dr. Gowda holds stock and/or stock options in Visualase and BioTex, Inc. Dr. Gross has received research support from Visualase, Inc." @default.
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• W125383485 date "2013-02-12" @default.
• W125383485 modified "2023-09-30" @default.
• W125383485 title "Real-Time MRI-Guided Stereotactic Laser Thermal Amygdalohippocampotomy (SLTAH) for Refractory Mesial Temporal Lobe Epilepsy (PD4.007)" @default.
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