A new approach to laser interstitial thermal therapy for drug-resistant temporal lobe epilepsy

Takeaway

  • Compared to the standard single-trajectory approach, two-trajectory laser ablation of medial temporal lobe (MTL) structures achieved a greater degree of ablated tissue and superior seizure outcomes in patients with medial temporal lobe epilepsy (mTLE).

Why this matters

  • Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (LITT) is a potential option for patients with drug-resistant mTLE. Although anterior temporal lobectomy is the current gold standard, MRI-guided LITT is growing in popularity, being minimally invasive and achieving excellent seizure outcomes.

  • Optimization of laser trajectories is an important focus in LITT. In mTLE, for example, it is challenging to ablate all target tissues with a single laser due to the geometric orientation of the piriform cortex versus amygdalohippocampal structures.

  • It is possible that a two-trajectory approach could maximize the volume of ablated tissue in patients with mTLE.