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.
