Laser thermal ablation in epilepsy.

Introduction:Many different types of surgical procedures are available for patients with drug-resistant epilepsy. MRI-guided laser interstitial thermal therapy is a stereotactic procedure with the potential to provide excellent seizure outcomes, while minimizing surgical approach related complications.Areas covered:This review will cover the role of MRgLITT in the treatment of multiple facets of epilepsy including temporal lobe epilepsy, nodular heterotopias, hypothalamic hamartomas, as well as corpus Callosotomy.Expert opinion:The development of magnetic resonance thermography has advanced continuous monitoring of thermal tissue destruction of pathological tissue in near real-time to allow for individualized neurological care for a person with epilepsy. Overall the results of MRgLITT appear similar to larger open forms of epilepsy surgery though with the promise of a safer side-effect profile. To improve this technique we must develop intraoperative biomarkers of procedural success, and develop tools to improve our patient selection.