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Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy.

Publication ,  Journal Article
Le, S; Ho, AL; Fisher, RS; Miller, KJ; Henderson, JM; Grant, GA; Meador, KJ; Halpern, CH
Published in: Epilepsy Behav
December 2018

BACKGROUND: Laser interstitial thermal therapy (LITT) is a minimally invasive alternative with less cognitive risks compared with traditional surgery for focal drug-resistant epilepsy. OBJECTIVE: We describe seizure outcomes and complications after LITT in our cohort with intractable mesial temporal lobe epilepsy (MTLE). MATERIAL AND METHODS: We prospectively tracked Stanford's MTLE cases treated with LITT from October 2014 to October 2017. Primary endpoints were seizure outcomes by (1) Engel classification and (2) reduction in baseline seizure frequency. Secondary outcomes were postablation complications. RESULTS: A total of 30 patients underwent selective amygdalohippocampotomy via LITT. Mesial temporal sclerosis (MTS) was present in 23/30 (77%) patients. Median follow-up was 18 ± 12 months (range: 6-44 months). Almost all 28/29 (97%) patients had >50% reduction, and 22/29 (76%) patients had >90% reduction in seizure frequency. Engel Class I outcome was achieved in 18/29 (62%) patients; with complete seizure freedom in 9/29 (31%) patients (Engel Class IA). Three (10%) patients have had only focal aware seizures (Engel Class 1B). Seizures only occurred with medication withdrawal in 6/29 (21%) patients (Engel Class ID). Class II was achieved by 6/29 (21%) and Class III by 5/29 (17%) patients. Complications included perioperative seizures in 10/29 (34%) and nonseizure complaints in 6/29 (21%) patients. Three (10%) patients had neurological deficits including one permanent superior quadrantanopsia, one transient trochlear, and one transient oculomotor nerve palsy. CONCLUSIONS: Overall, Engel Class I outcome was achieved in 62% of patients with MTLE, and 97% of patients achieved >50% seizure frequency reduction. Complications were largely temporary, though there was one persistent visual field deficit. Laser ablation is well-tolerated and offers marked seizure reduction for the majority of patients.

Duke Scholars

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

December 2018

Volume

89

Start / End Page

37 / 41

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Seizures
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Laser Therapy
  • Humans
  • Female
 

Citation

APA
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ICMJE
MLA
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Le, S., Ho, A. L., Fisher, R. S., Miller, K. J., Henderson, J. M., Grant, G. A., … Halpern, C. H. (2018). Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy. Epilepsy Behav, 89, 37–41. https://doi.org/10.1016/j.yebeh.2018.09.040
Le, Scheherazade, Allen L. Ho, Robert S. Fisher, Kai J. Miller, Jaimie M. Henderson, Gerald A. Grant, Kimford J. Meador, and Casey H. Halpern. “Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy.Epilepsy Behav 89 (December 2018): 37–41. https://doi.org/10.1016/j.yebeh.2018.09.040.
Le S, Ho AL, Fisher RS, Miller KJ, Henderson JM, Grant GA, et al. Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy. Epilepsy Behav. 2018 Dec;89:37–41.
Le, Scheherazade, et al. “Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy.Epilepsy Behav, vol. 89, Dec. 2018, pp. 37–41. Pubmed, doi:10.1016/j.yebeh.2018.09.040.
Le S, Ho AL, Fisher RS, Miller KJ, Henderson JM, Grant GA, Meador KJ, Halpern CH. Laser interstitial thermal therapy (LITT): Seizure outcomes for refractory mesial temporal lobe epilepsy. Epilepsy Behav. 2018 Dec;89:37–41.
Journal cover image

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

December 2018

Volume

89

Start / End Page

37 / 41

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Seizures
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Laser Therapy
  • Humans
  • Female