Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T08:17:41.210Z Has data issue: false hasContentIssue false

Chapter 19 - Ablative Surgery for Medication-Resistant Epilepsy

Published online by Cambridge University Press:  20 August 2020

John M. Stern
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Raman Sankar
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Michael Sperling
Affiliation:
Jefferson Hospital for Neurosciences, Philadelphia, PA
Get access

Summary

Medication-resistant epilepsy continues to be a challenging condition, but numerous medical as well as surgical treatment options developed over the years have added significantly to the therapeutic arsenal of both neurologists and neurosurgeons. One such approach to epileptic patients focuses around physically disrupting their epileptogenic circuitry, with relevant modalities including traditional open surgical resection and radiosurgery, as well as ablation via radiofrequency, cryotherapy or laser interstitial thermal therapy [1–10]. The interest in less-invasive methods for control of medication-resistant epilepsy has been motivated by several factors, including: reducing perioperative morbidity, decreasing length of stay and associated complications/costs, and offering treatments for patients that are otherwise not eligible for traditional surgical resections, be it for reasons related to medical comorbidities or factors inherent to their epileptic pathology. Additionally, the perceived risks of open craniotomy may play a role in limiting both the number of patients referred to tertiary epilepsy centres by primary care physicians, as well as the number of patients willing to undergo traditional open resection, even in the face of significant evidence in support of the safe role of surgery in refractory epilepsy [11]. Stereotactic laser ablation (SLA) is among the most relevant surgical advances in the treatment of drug-resistant epilepsy, offering the benefit of high rates of seizure control in epileptic patients with varying underlying seizure aetiologies, combined with minimization of the amount of normal cerebral tissue disrupted due to the advent of real-time image-guided feedback [3,4,5,8,10,12].

Type
Chapter
Information
Medication-Resistant Epilepsy
Diagnosis and Treatment
, pp. 210 - 218
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Liscak, R, Malikova, H, Kalina, M, et al. Stereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy. Acta Neurochir 2010;152(8):12911298CrossRefGoogle ScholarPubMed
Chkhenkeli, SA, Šramka, M, Rakviashvili, TN, et al. Bitemporal intractable epilepsy: could it be surgically treatable? Stereotact Funct Neurosurg 2013;91(2):104112CrossRefGoogle ScholarPubMed
Gonzalez-Martinez, J, Vadera, S, Mullin, J, et al. Robot-assisted stereotactic laser ablation in medically intractable epilepsy: operative technique. Neurosurgery 2014;10(suppl 2):167172Google ScholarPubMed
Wilfong, AA, Curry, DJ. Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis. Epilepsia 2013;54(Suppl 9):109114Google Scholar
Tovar-Spinoza, Z, Carter, D, Ferrone, D, et al. The use of MRI-guided laser-induced thermal ablation for epilepsy. Childs Nerv Syst 2013;29(11):20892094CrossRefGoogle ScholarPubMed
Curry, DJ, Gowda, A, McNichols, RJ, et al. MR-guided stereotactic laser ablation of epileptogenic foci in children. Epilepsy Behav 2012;24(4):408414Google Scholar
Wu, C, Lariviere, MJ, Laxpati, N, et al. Extraventricular long-axis cannulation of the hippocampus: technical considerations. Neurosurgery 2014;10(Suppl 2):325332Google ScholarPubMed
Willie, JT, Laxpati, NG, Drane, DL, et al. Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery 2014;74(6):569584Google Scholar
Quigg, M, Rolston, J, Barbaro, NM. Radiosurgery for epilepsy: clinical experience and potential antiepileptic mechanisms. Epilepsia 2012;53(1):715Google Scholar
Kang, JY, Wu, C, Tracy, J, et al. Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy. Epilepsia 2016;57(2):325334CrossRefGoogle ScholarPubMed
Bandt, KS, Leuthardt, EC. Minimally invasive neurosurgery for epilepsy using stereotactic MRI guidance. Neurosurg Clin N Am 2016;27(1):5158CrossRefGoogle ScholarPubMed
Esquenazi, Y, Kalamangalam, GP, Slater, JD, et al. Stereotactic laser ablation of epileptogenic periventricular nodular heterotopia. Epilepsy Res 2014;108(3):547554Google Scholar
Quigg, M, Harden, C. Minimally invasive techniques for epilepsy surgery: stereotactic radiosurgery and other technologies. J Neurosurg 2014;121(Suppl):232240CrossRefGoogle ScholarPubMed
Carpentier, A, McNichols, RJ, Stafford, RJ, et al. Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors. Neurosurgery 2008;63(1):2129Google Scholar
Medvid, R, Ruiz, A, Komotar, RJ, et al. Current applications of MRI-guided laser interstitial thermal therapy in the treatment of brain neoplasma and epilepsy: a radiologic and neurosurgical overview. Am J Neuroradiol 2015;36(11):19982006Google Scholar
Kangasniemi, M, McNichols, RJ, Bankson, JA, et al. Thermal therapy of canine cerebral tumor using a 980 nm diode laser with MR temperature-sensitive imaging feedback. Lasers Surg Med 2004;35(1):4150CrossRefGoogle ScholarPubMed
Gross, RE, Willie, JT, Mehta, AD, et al. Multicenter experience with minimally invasive stereotactic laser thermal amygdalohippocampotomy for mesial temporal lobe epilepsy. Abstract and Platform Presentation, American Association of Neurological Surgeons, New Orleans, 2013.Google Scholar
Abla, A, Shetter, AG, Chang, SW, et al. Gamma Knife surgery for hypothalamic hamartomas and epilepsy: patient selection and outcomes. J Neurosurg 2010;113(Suppl):207214Google Scholar
Rolston, JD, Chang, EF. Stereotactic laser ablation for hypothalamic hamartoma. Neurosurg Clin N Am 2016;27(1):5967Google Scholar
Rosenfeld, JV, Feiz-Erfan, I. Hypothalamic hamartoma treatment: surgical resection with the transcallosal approach. Semin Pediatr Neurol 2007;14(2):8898Google Scholar
Clarke, DF, Tindall, K, Lee, M, et al. Bilateral occipital dysplasia, seizure identification, and ablation: a novel surgical technique. Epileptic Discord 2014;16(2):238243Google Scholar
Lewis, EC, Weil, AG, Duchowny, M, et al. MR-guided laser interstitial thermal therapy for pediatric drug-resistant lesional epilepsy. Epilepsia 2015;56(10):15901598Google Scholar
Buckley, R, Estronza-Ojeda, S, Ojemann, JG. Laser ablation in pediatric epilepsy. Neurosurg Clin N Am 2016;27(1):6978Google Scholar
Gross, RE, Willie, JT, Drane, DL. The role of stereotactic laser amygdalohippocampotomy in mesial temporal lobe epilepsy. Neurosurg Clin N Am 2016;27(1):3750Google Scholar
Gross, RE, Mahmoudi, B, Riley, JP. Less is more: novel less-invasive surgical techniques for mesial temporal lobe epilepsy that minimize cognitive impairment. Curr Opin Neurol 2015;28(2):182191CrossRefGoogle ScholarPubMed
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):101113CrossRefGoogle ScholarPubMed
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;51:152157CrossRefGoogle ScholarPubMed
Zubkov, S, Del Bene, VA, MacAllister, WS, et al. Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy. Epilepsy Behav Case Rep 2015;10(4):6062CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×