Islam Fayed1, Matthew F Sacino2, Willilam D Gaillard3, Robert F Keating4, Chima O Oluigbo4. 1. Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA. 2. Georgetown University School of Medicine, Washington, District of Columbia, USA. 3. Department of Neurology, Children's National Medical Center, Washington, District of Columbia, USA. 4. Division of Neurosurgery, Children's National Medical Center, Washington, District of Columbia, USA.
Abstract
INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay. OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy. METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed. Demographic and outcome data were compiled and analyzed. RESULTS: Twelve pediatric patients with a total 18 lesions underwent MRgLITT procedures between December 2013 and September 2017. Mean age at surgery was 11.1 years. Surgical substrates included 4 hypothalamic hamartomas, 3 periventricular heterotopias, 2 deep focal cortical dysplasias, 2 tuberous sclerosis, and 1 mesial temporal sclerosis. Methods of stereotaxis used included Leksell frame, BrainLab VarioGuide, ROSA robot guidance, and ClearPoint navigation. Mean procedure length was 250 min, and mean length of stay was 1.3 days. After treatment, 8 patients were seizure free (Engel I, 66.7%), 2 patients demonstrated significant improvement (Engel II, 16.7%), and 2 patients showed worthwhile improvement (Engel III, 16.7%). One patient developed a left superior quadrantanopsia postoperatively. Mean follow-up duration was 10 months. CONCLUSION: This study contributes to the sparse literature in this field by demonstrating the high efficacy and low morbidity of MRgLITT as a minimally invasive method of ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.
INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay. OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy. METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed. Demographic and outcome data were compiled and analyzed. RESULTS: Twelve pediatric patients with a total 18 lesions underwent MRgLITT procedures between December 2013 and September 2017. Mean age at surgery was 11.1 years. Surgical substrates included 4 hypothalamic hamartomas, 3 periventricular heterotopias, 2 deep focal cortical dysplasias, 2 tuberous sclerosis, and 1 mesial temporal sclerosis. Methods of stereotaxis used included Leksell frame, BrainLab VarioGuide, ROSA robot guidance, and ClearPoint navigation. Mean procedure length was 250 min, and mean length of stay was 1.3 days. After treatment, 8 patients were seizure free (Engel I, 66.7%), 2 patients demonstrated significant improvement (Engel II, 16.7%), and 2 patients showed worthwhile improvement (Engel III, 16.7%). One patient developed a left superior quadrantanopsia postoperatively. Mean follow-up duration was 10 months. CONCLUSION: This study contributes to the sparse literature in this field by demonstrating the high efficacy and low morbidity of MRgLITT as a minimally invasive method of ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy.
Authors: Hepzibha Alexander; Kelsey Cobourn; Islam Fayed; Dewi Depositario-Cabacar; Robert F Keating; William D Gaillard; Chima O Oluigbo Journal: Childs Nerv Syst Date: 2019-01-09 Impact factor: 1.475
Authors: Elsa V Arocho-Quinones; Sean M Lew; Michael H Handler; Zulma Tovar-Spinoza; Matthew Smyth; Robert Bollo; David Donahue; M Scott Perry; Michael L Levy; David Gonda; Francesco T Mangano; Phillip B Storm; Angela V Price; Daniel E Couture; Chima Oluigbo; Ann-Christine Duhaime; Gene H Barnett; Carrie R Muh; Michael D Sather; Aria Fallah; Anthony C Wang; Sanjiv Bhatia; Kadam Patel; Sergey Tarima; Sarah Graber; Sean Huckins; Daniel M Hafez; Kavelin Rumalla; Laurie Bailey; Sabrina Shandley; Ashton Roach; Erin Alexander; Wendy Jenkins; Deki Tsering; George Price; Antonio Meola; Wendi Evanoff; Eric M Thompson; Nicholas Brandmeir Journal: J Neurosurg Pediatr Date: 2020-03-27 Impact factor: 2.375
Authors: Franco Rubino; Daniel G Eichberg; Joacir G Cordeiro; Long Di; Karen Eliahu; Ashish H Shah; Evan M Luther; Victor M Lu; Ricardo J Komotar; Michael E Ivan Journal: J Robot Surg Date: 2021-07-13