Technical challenges to anterior temporal lobectomy after laser interstitial thermal therapy for mesial temporal lobe epilepsy: technical note

View More View Less
  • 1 Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $45.00
USD  $515.00
USD  $612.00
Print or Print + Online Sign in

Mesial temporal sclerosis (MTS) is a frequent cause of medically refractory epilepsy, for which laser interstitial thermal therapy (LITT) is an effective treatment. However, experience with the technical considerations posed by additional surgery after an initial LITT procedure is lacking. The authors present the case of a 12-year-old female with medically refractory temporal lobe epilepsy and left MTS who underwent LITT at a separate institution prior to referral. This patient had no change in early postoperative seizure control (Engel class IVB) and then her seizures worsened despite ongoing medical treatment (Engel class IVC). Post-LITT MRI revealed sparing of the mesial hippocampus head, a poor prognostic factor. The authors describe the technical details illustrated by this case of secondary, stereotactic electroencephalography–guided mesial temporal resection following LITT. The case was managed with anterior temporal lobectomy including the resection of residual hippocampus and amygdala.

ABBREVIATIONS

ATL = anterior temporal lobectomy; CSF = cerebrospinal fluid; iMRI = intraoperative MRI; LITT = laser interstitial thermal therapy; MTS = mesial temporal sclerosis; SEEG = stereotactic electroencephalography.
Illustration from Cinalli et al. (pp 119–127). Printed with permission from © CC Medical Arts.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $515.00
USD  $612.00
  • 1

    Wu C, Jermakowicz WJ, Chakravorti S, et al. Effects of surgical targeting in laser interstitial thermal therapy for mesial temporal lobe epilepsy: a multicenter study of 234 patients. Epilepsia. 2019;60(6):11711183.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Engel J Jr. Etiology as a risk factor for medically refractory epilepsy: a case for early surgical intervention. Neurology. 1998;51(5):12431244.

  • 3

    Hale AT, Sen S, Haider AS, et al. Open resection versus laser interstitial thermal therapy for the treatment of pediatric insular epilepsy. Neurosurgery. 2019;85(4):E730E736.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    McIntosh AM, Wilson SJ, Berkovic SF. Seizure outcome after temporal lobectomy: current research practice and findings. Epilepsia. 2001;42(10):12881307.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Prince E, Hakimian S, Ko AL, Ojemann JG, Kim MS, Miller JW. Laser interstitial thermal therapy for epilepsy. Curr Neurol Neurosci Rep. 2017;17(9):63.

  • 6

    Hoppe C, Witt JA, Helmstaedter C, Gasser T, Vatter H, Elger CE. Laser interstitial thermotherapy (LiTT) in epilepsy surgery. Seizure. 2017;48:4552.

  • 7

    Jermakowicz WJ, Kanner AM, Sur S, et al. Laser thermal ablation for mesiotemporal epilepsy: analysis of ablation volumes and trajectories. Epilepsia. 2017;58(5):801810.

  • 8

    Kang JY, Wu C, Tracy J, et al. Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy. Epilepsia. 2016;57(2):325334.

  • 9

    Willie JT, Laxpati NG, Drane DL, et al. Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery. 2014;74(6):569585.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Dredla BK, Lucas JA, Wharen RE, Tatum WO. Neurocognitive outcome following stereotactic laser ablation in two patients with MRI-/PET+ mTLE. Epilepsy Behav. 2016;56:4447.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Gross RE, Willie JT, Drane DL. The role of stereotactic laser amygdalohippocampotomy in mesial temporal lobe epilepsy. Neurosurg Clin N Am. 2016;27(1):3750.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Drane DL, Willie JT, Pedersen NP, et al. Superior verbal memory outcome after stereotactic laser amygdalohippocampotomy. Front Neurol. 2021;12:779495.

Metrics

All Time Past Year Past 30 Days
Abstract Views 623 623 55
Full Text Views 80 80 20
PDF Downloads 139 139 47
EPUB Downloads 0 0 0