Effects of surgical targeting in laser interstitial thermal therapy for mesial temporal lobe epilepsy: A multicenter study of 234 patients.
Chengyuan WuWalter J JermakowiczSrijata ChakravortiIahn CajigasAshwini D SharanJonathan R JagidCaio M MatiasMichael R SperlingRobert BuckleyAndrew KoJeffrey G OjemannJohn W MillerBrett E YoungermanSameer A ShethGuy M McKhannAdrian W LaxtonDaniel E CoutureGautam S PopliAlexander SmithAshesh D MehtaAllen L HoCasey H HalpernDario J EnglotJoseph S NeimatPeter E KonradElliot G NealFernando L ValeKathryn L HollowayEllen L AirJason SchwalbBenoit M DawantPierre-Francois D'HaesePublished in: Epilepsia (2019)
LITT is a viable treatment for mTLE in patients who have been properly evaluated at a comprehensive epilepsy center. Consideration of surgical factors is imperative to the complete assessment of LITT. Based on our model, ablations must prioritize the amygdala and also include the hippocampal head, parahippocampal gyrus, and rhinal cortices to maximize chances of seizure freedom. Extending the ablation posteriorly has diminishing returns. Further work is necessary to refine this analysis and define the minimal zone of ablation necessary for seizure control.