laser interstitial thermal therapy (litt): seizure ... · •litt is a novel, minimally invasive...

LaserInterstitialThermalTherapy(LITT):seizureoutcomesforintractable

mesialtemporalepilepsy

ScheherazadeLeMD,AllenHoMD,KaiJ.MillerMDPhD,RobertS.FisherMDPhD,JaimieHendersonMD,GeraldGrantMDFACS,

Kimford MeadorMD, CaseyH.HalpernMD

Disclosures:None

Rationale&Methods

• LITTisanovel,minimallyinvasivealternativetoconventionalopensurgery.

• Intractablemesialtemporalepilepsy• October2014-2016• Outcomes:– seizures(Engelclassification,frequency)– complications

Results

• 22patientsà 1losttofollow-up

• Ages19– 70– 10patients(45%)>age50

• MRI:MTS+in16/22(73%)• Lasertargets– 8rightanteriorhippocampus– 14leftanteriorhippocampus

Atotalof11/21(52%)patientsà EngelClassI

• 21/21(100%)>50%reductionbaselinesz frequency• 15/21(71%)>90%reductionbaselinesz frequency

IA

IBII

III

Immediatepost-opsz:1/22(missedAED)Perioperativesz (<14dafter):5/21(24%)

Results:Non-seizureComplications

• 4/22(18%)– Targetingerrorà catheterrepositionedtwice• transientpartialCNIIIpalsy,asepticmeningitis,statusmigrainosus

– Otherminorcomplications:• homonymoushemianopsiaà superiorquadrantanopia• self-limitedileus• HAinapatientwithco-morbidmigraines

Conclusions• EngelClassIorII=85%• Allpatientshad>50%reductioninbaselineszfrequency;majority(71%)>90%reduction.

• ComplicationsofLITTwereuncommonandlargelytransient.– Perioperativesz in24%

• LITTisasafe,minimallyinvasive,well-toleratedprocedure.