Laser interstitial thermal therapy may offer seizure freedom in drug-resistant epilepsy

Key takeaways:

• Retrospective chart review included 29 patients with drug-resistant epilepsy who underwent LITT.
• Better 1-year outcomes reported in patients with temporal lobe epilepsy compared with extratemporal lobe epilepsy.

BOSTON — Laser interstitial thermal therapy may offer seizure freedom to select patients, particularly those with drug-resistant temporal lobe epilepsy, according to a poster at the American Academy of Neurology annual meeting.

“Our research serves to clarify the different patient characteristics that could predict better seizure freedom outcome after [laser interstitial thermal therapy],” Emily In, BS, of the University of Pittsburgh School of Medicine, told Healio.

In and colleagues sought to examine whether a minimally-invasive surgical technique like laser interstitial thermal therapy (LITT) could lead to greater seizure freedom in those with drug-resistant temporal lobe (TLE) and extratemporal lobe epilepsy (ETLE).

They conducted a retrospective chart review using data from the University of Pittsburgh’s Comprehensive Epilepsy Center and identified 29 individuals (24 with TLE, 5 with ETLE) who underwent LITT from 2015 to 2019. Researchers collected information on patient demographics, seizure etiology, duration of epilepsy, methods of presurgical testing, acute and chronic postoperative neurological complications and seizure freedom outcomes at 3, 6, 12, 24 and 48 months and at the last clinical visit.

Researchers reported that 19 of 29 individuals were seizure-free 1 year after LITT and 13 of 29 were seizure-free at the last clinical visit. Seizure-freedom at the last visit was reported among 50% and 20% of patients with TLE and ETLE, respectively. However, the difference in proportion of seizure freedom between groups was not statistically significant, in part because of a limited sample size.

Five individuals had acute postoperative complications, including headache, epidermal hematoma, blurred vision, delirium and pain and numbness in extremities, and two patients reported chronic postoperative complications of impaired memory and comprehension. No analyzed factors were associated with seizure recurrence.

“We found that patients with temporal lobe epilepsy have slightly better seizure outcomes than those with extratemporal lobe epilepsy, but more research needs to be done with a larger sample size,” In said.