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Magnetic resonance imaging-guided laser interstitial thermal therapy for complete corpus callosotomy: technique and 1-year outcomes. Patient series. J Neurosurg Case Lessons 2022 Dec 19;4(25)

Date

12/21/2022

Pubmed ID

36536524

Pubmed Central ID

PMC9764374

DOI

10.3171/CASE22364

Scopus ID

2-s2.0-85165185428 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Magnetic resonance imaging (MRI)-guided stereotactic laser interstitial thermal therapy (LITT) is a minimally invasive technique that has been described for the treatment of certain forms of epilepsy through partial or complete callosotomy, with few cases describing single-stage complete LITT callosotomy. The authors aimed to demonstrate this technique's feasibility and efficacy through description of the technique and 1-year outcomes in 3 cases of single-stage complete LITT callosotomy in patients with anatomically normal corpa callosa (CCs).

OBSERVATIONS: The patients were aged 14-27 years and experienced atonic seizures. Completeness of callosotomy was determined from MRI scans obtained >3 months after LITT procedures. The estimated ablations of the CC were 94%, 89%, and 100%, respectively. The second patient had a catheter breach the lateral ventricle, resulting in the lowest estimated percentage of ablation in this series (89%), with minimal atonic seizure reduction. The first patient had significant reduction in atonic seizure frequency, and the third patient had complete resolution of atonic seizures. None of the patients experienced any long-term complications. Intensive care length of stay was 1 night for each patient, and total length of stay was between 2 and 7 nights. Postoperative follow-up was between 14 and 18 months.

LESSONS: Complete laser callosotomy is achievable and is a safe alternative to microsurgical or endoscopic approaches.

Author List

Best BJ, Kim I, Lew SM

Authors

Irene Kim MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
Sean Lew MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin