Laser interstitial thermal therapy after failed anterior temporal lobectomy and amygdalohippocampectomy can improve seizure outcome.
Epilepsy Behav Rep
; 14: 100366, 2020.
Article
em En
| MEDLINE
| ID: mdl-32518903
ABSTRACT
Anterior temporal lobectomy and amygdalohippocampectomy (ATL) is the gold standard surgical treatment for drug resistant mesial temporal lobe epilepsy (mTLE). Nevertheless, seizure recurrence after ATL is not uncommon. Insufficient resection of the mesial temporal structures remains one of the most common reasons for ATL failure. Extending the resection leads to improved seizure outcome in a majority of patients. However, repeat craniotomy can be higher risk for the patient and also can be technically challenging due to scarring and altered anatomy. Laser interstitial thermal therapy (LITT) is a novel minimally invasive alternative to ATL, and it has been shown to be safe and effective. However, it is unclear if LITT has a role in managing post-ATL mTLE patients with recurrent seizures and residual epileptogenic structures. LITT is an attractive option for post-ATL patients with residual mesial structures because the surgery is minimally invasive, and it allows precise targeting and real time confirmation of tissue ablation under MRI guidance. We present a case of an mTLE patient with recurrent seizures after ATL who achieved long-term seizure-freedom after successfully undergoing LITT to ablate the residual hippocampus. This approach, if demonstrated to be safe, effective and durable, can benefit select post-ATL mTLE patients.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
Idioma:
En
Revista:
Epilepsy Behav Rep
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos