Consales Alessandro, Cognolato Erica, Pacetti Mattia, Mancardi Maria Margherita, Tortora Domenico, Di Perna Giuseppe, Piatelli Gianluca, Nobili Lino
Unit of Neurosurgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy.
DINOGMI, University of Genoa, Genoa, Italy.
Front Neurol. 2021 Oct 26;12:739034. doi: 10.3389/fneur.2021.739034. eCollection 2021.
Magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT) is a novel minimally invasive treatment approach for drug-resistant focal epilepsy and brain tumors. Using thermal ablation induced by a laser diode implanted intracranially in a stereotactic manner, the technique is highly effective and safe, reducing the risk associated with more traditional open surgical approaches that could lead to increased neurological morbidity. Indications for MR-gLiTT in pediatric epilepsy surgery include hypothalamic hamartoma, tuberous sclerosis complex, cavernoma-related epilepsy, SEEG-guided seizure onset zone ablation, corpus callosotomy, periventricular nodular heterotopia, mesial temporal lobe epilepsy, and insular epilepsy. We review the available literature on the topic and present our series of patients with drug-resistant epilepsy treated by MR-gLiTT. Our experience, represented by six cases of hypothalamic hamartomas, one case of tuberous sclerosis, and one case of dysembryoplastic neuroepithelial tumor, helps to confirm that MR-gLiTT is a highly safe and effective procedure for several epilepsy conditions in children.
磁共振引导激光间质热疗（MR - gLiTT）是一种针对耐药性局灶性癫痫和脑肿瘤的新型微创治疗方法。该技术通过立体定向方式将激光二极管颅内植入诱导热消融，具有高效且安全的特点，降低了与更传统的开放手术方法相关的风险，而传统手术可能会增加神经功能障碍的发生率。MR - gLiTT在小儿癫痫手术中的适应症包括下丘脑错构瘤、结节性硬化症、海绵状血管瘤相关性癫痫、皮层脑电图（SEEG）引导下的癫痫发作起始区消融、胼胝体切开术、脑室周围结节性异位、内侧颞叶癫痫和岛叶癫痫。我们回顾了关于该主题的现有文献，并展示了我们通过MR - gLiTT治疗的耐药性癫痫患者系列。我们的经验，以6例下丘脑错构瘤、1例结节性硬化症和1例胚胎发育不良性神经上皮肿瘤为例，有助于证实MR - gLiTT对于儿童多种癫痫病症是一种高度安全有效的手术。
