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New MRI-Guided Laser Technique Helps Epileptics

June 3, 2014
Written by: , Filed in: Interventional Radiology, Neuroradiology
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A new MRI-guided laser technique can help patients suffering from drug-resistant epilepsy without the dangers of conventional surgery, according to research led by neurosurgeons at Emory University School of Medicine in Atlanta.

“Real-time magnetic resonance–guided stereotactic laser amygdalohippocampotomy is a technically novel, safe, and effective alternative to open surgery,” concludes the abstract of an article about the technique that was published in the June issue of Neurosurgery.

The researchers tried the technique on 13 adult patients with mesial temporal lobe epilepsy. Antiepileptic drugs had not controlled their seizures. The standard treatment for such a condition is open brain surgery. That’s usually successful, but it carries significant risks of neurological and cognitive impairment.

Instead, the researchers used MRI to guide a fiber-optic laser probe directly to the area of the brain responsible for seizure activity: the amygdalohippocampal complex (AHC). The laser ablated the target tissue without harming neighboring tissue.

Average laser exposure time was less than 10 minutes. Median time spent in the hospital was one day, compared to the two- to five-day stay that’s typical with conventional surgery.

A median of 14 months after the new procedure, 10 of the 13 patients had what the study authors called “meaningful seizure reduction,” and 7 of those 10 had no seizures at all. Overall, the authors called the procedure a success:

We found that ablation of the AHC is safe, associated with brief hospitalizations, and effective: most patients achieved seizure freedom.

A larger, longer-term study of the procedure is under way. It will assess, among other things, cognitive function in study subjects, which this first study did not measure.

If more extensive studies yield similar results, the authors suggest, then epilepsy patients nervous about the side effects of conventional surgery may be willing to consider this less-scary alternative: “Such minimally invasive techniques may be more desirable to patients and result in increased use of epilepsy surgery among the large number of medically intractable epilepsy patients.”

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