MR-guided laser interstitial thermal therapy for pediatric drug-resistant lesional epilepsy

摘要: Summary Objective To report the feasibility, safety, and clinical outcomes of an exploratory study MR-guided Laser Interstitial Thermal Therapy (MRgLITT) as a minimally invasive surgical procedure for ablation epileptogenic foci in children with drug-resistant, lesional epilepsy. Methods Retrospective chart review all MRgLITT procedures at single tertiary care center. All were performed using U.S. Food Drug Administration (FDA)–cleared laser system (Visualase System). Predefined variables extracted from archived medical records. Results Seventeen patients underwent 19 May 2011 to January 2014. Mean age seizure onset was 7.1 years (range 0.1–14.8 years). surgery 15.3 years 5.9–20.6 years). Surgical substrates mixed but mainly composed focal cortical dysplasia (n = 11). Complications occurred four patients. Average length hospitalization postsurgery 1.56 days. follow-up 16.1 months (n = 16; range 3.5–35.9 months). Engel class I outcome achieved seven (7/17; 41%), II one (1/17; 6%), III three (3/17; 18%), IV six (6/17; 35%). Three (3/8; 38%) five (5/9; 56%) had least prior resection. Fisher's exact test not statistically significant association between previous resection (p = 0.64). Significance This provides descriptive results regarding use population pediatric, lesional, drug-resistant epilepsy cases. The ability classify case-specific reduce technical complications is anticipated experience develops. Further multicenter, prospective studies are required delineate optimal candidates MRgLITT, larger cohorts needed more accurately define complication rates.