HEALINE

Targeted Laser Surgery Treats Temporal Lobe Epilepsy

Engel I outcomes more likely with ablations targeting specific lobe structures

WEDNESDAY, May 22, 2019 (Pharmacist's Briefing) -- Laser interstitial thermal therapy (LITT) targeting greater amygdala volume is more likely to be associated with Engel I outcomes for mesial temporal lobe epilepsy (mTLE), according to a study published online May 21 in Epilepsia.

Chengyuan Wu, M.D., from the Vickie and Jack Farber Institute for Neuroscience at Thomas Jefferson University in Philadelphia, and colleagues conducted a multicenter cohort study involving 234 patients from 11 centers who underwent LITT for mTLE. The correlation of clinical variables and ablation location to seizure outcome was calculated.

The researchers found that Engel I outcomes were more likely to be associated with ablations including more anterior, medial, and inferior temporal lobe structures, which involved greater amygdalar volume. Fifty-eight percent of participants achieved Engel I outcomes at both one and two years after LITT. The chances of Engel I outcome were decreased with a history of bilateral tonic-clonic seizures. There was no correlation for radiographic hippocampal sclerosis with seizure outcome.

"These studies are helping us provide patients with a surgical option that is less invasive -- and these results bring us closer to outcomes similar to open-brain surgery in properly selected patients," Wu said in a statement. "We've shown that some areas are not as effective targets as others, which means we can ablate less to get the same results, with fewer side effects."

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

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