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用于治疗癫痫的激光间质热疗法:迄今的证据。

Laser interstitial thermal therapy for the treatment of epilepsy: evidence to date.

作者信息

Shukla Navika D, Ho Allen L, Pendharkar Arjun V, Sussman Eric S, Halpern Casey H

机构信息

Department of Neurosurgery, Stanford University, Stanford, CA, USA.

出版信息

Neuropsychiatr Dis Treat. 2017 Sep 26;13:2469-2475. doi: 10.2147/NDT.S139544. eCollection 2017.

Abstract

Medically intractable epilepsy is associated with increased morbidity and mortality. For those with focal epilepsy and correlated electrophysiological or radiographic features, open surgical resection can achieve high rates of seizure control, but can be associated with neurologic deficits and cognitive effects. Recent innovations have allowed for more minimally invasive methods of surgical seizure control such as magnetic resonance-guided laser interstitial therapy (MRgLITT). MRgLITT achieves the goal of ablating seizure foci while preserving neuropsycho-logical function and offering real-time feedback and monitoring of tissue ablation. This review summarizes the utilization of MRgLITT for mesial temporal lobe epilepsy and other seizure disorders. Overall, the efficacy of MRgLITT is comparable to that of open surgery and offers a less invasive approach in patients with significantly less morbidity.

摘要

药物难治性癫痫与发病率和死亡率增加相关。对于那些具有局灶性癫痫及相关电生理或影像学特征的患者,开放性手术切除可实现较高的癫痫控制率,但可能伴有神经功能缺损和认知影响。最近的创新使得手术控制癫痫的方法更加微创,如磁共振引导激光间质热疗(MRgLITT)。MRgLITT在保留神经心理功能的同时实现了切除癫痫病灶的目标,并提供了组织消融的实时反馈和监测。本综述总结了MRgLITT在颞叶内侧癫痫和其他癫痫疾病中的应用。总体而言,MRgLITT的疗效与开放性手术相当,并且为发病率显著较低的患者提供了一种侵入性较小的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a80/5627747/b24d934c9d4d/ndt-13-2469Fig1.jpg

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