Impact of Previous Surgery on Success of Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) to Treat Pediatric Epilepsy: An Institutional Experience.
World Neurosurg
; 186: e707-e712, 2024 06.
Article
en En
| MEDLINE
| ID: mdl-38616023
ABSTRACT
BACKGROUND:
There is an emerging role for minimally invasive magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) in the treatment of pediatric epilepsy refractory to medication. To date, predictors of MRgLITT success have not been established in a sizeable singular experience. Correspondingly, the aim of this study was to elucidate if previous surgical history predicts MRgLITT success in this setting.METHODS:
A retrospective review was conducted of our MRgLITT procedures for pediatric (patient age <19 years) epilepsy from 2011 to 2020 with documented seizure outcomes at 1 and 2 years after procedure. Categorical and continuous data were compared using χ2 and Student's t test, respectively.RESULTS:
A total of 41 patients satisfied all criteria with 16 (39%) female and 25 (61%) male patients. Following MRgLITT, seizure-freedom at 1-year was achieved in 15 (37%) patients. In the cohort, there were 14 (34%) patients who had undergone previous open surgery for epilepsy at mean age of 9.4 ± 5.5 years. Patients with a previous open surgery history were found to statistically experience longer length of hospitalization after MRgLITT (P = 0.04) with a statistically lower proportion of seizure-freedom at 1-year after MRgLITT (14% vs. 48%, P = 0.03). However, there was no difference in the rate of seizure-freedom at 2 years (29% vs. 41%, P = 0.44), as well as no difference in subsequent surgical interventions for seizure management between groups.CONCLUSIONS:
Based on our institutional experience, patients with previous open surgery history may experience longer length of hospitalization after MRgLITT for pediatric epilepsy and lesser response in seizure-freedom within the first year but with non-inferior seizure freedom by the second year.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Terapia por Láser
Límite:
Adolescent
/
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2024
Tipo del documento:
Article