Prince Eric, Hakimian Shahin, Ko Andrew L, Ojemann Jeffrey G, Kim Michelle S, Miller John W
Departments of Neurology and Neurological Surgery, University of Washington, Box 359745, 325 Ninth Ave, Seattle, WA, 98104, USA.
Departments of Neurological Surgery, University of Washington, Box 359745, 325 Ninth Ave, Seattle, WA, 98104, USA.
Curr Neurol Neurosci Rep. 2017 Sep;17(9):63. doi: 10.1007/s11910-017-0772-8.
MRI-guided laser interstitial thermal therapy (MgLiTT) uses a narrow diameter cannula to stereotactically target and heat deeper cerebral structures. This technique produces a precise lesion in the brain with great reliability because the localized tissue temperature change is monitored in real time. Because MgLiTT minimizes injury to surrounding brain, it appears to have a lower risk of affecting normal neurological function, and because it is done through a burr hole, there is less operative risk, less discomfort, and shorter hospitalizations. It is FDA approved for soft tissue ablation and is being increasingly applied to the surgical treatment of epilepsy, especially when seizures arise from deeper structures such as the hippocampus, amygdala, or discrete dysplastic tissue such as hypothalamic hamartomas. Mesial temporal epilepsy is the most frequently encountered surgically remedial epilepsy suitable for MgLiTT, particularly when there is unilateral hippocampal sclerosis. There is emerging evidence that it can be effective for eliminating seizures in this type of epilepsy, and that it has a lower risk of cognitive deficits than anterior temporal lobectomy.
磁共振成像引导激光间质热疗（MgLiTT）使用细直径套管针立体定向靶向并加热更深层的脑结构。由于能实时监测局部组织温度变化，该技术在脑部产生精确病灶的可靠性很高。由于MgLiTT将对周围脑组织的损伤降至最低，似乎影响正常神经功能的风险较低，并且由于它是通过骨孔进行的，手术风险较小、不适较少且住院时间较短。它已获得美国食品药品监督管理局（FDA）批准用于软组织消融，并且越来越多地应用于癫痫的外科治疗，尤其是当癫痫发作源于海马体、杏仁核等深层结构或下丘脑错构瘤等离散发育异常组织时。内侧颞叶癫痫是最常遇到的适合MgLiTT手术治疗的癫痫类型，特别是存在单侧海马硬化时。新出现的证据表明，它对消除这类癫痫发作有效，并且与前颞叶切除术相比，其认知缺陷风险较低。
