Authors :
Presenting Author: Moubon Kurukumbi, student – Inova Fairfax Hospital
Manar Haroon, BS – Inova Fairfax Hospital
James Leiphart, MD, PhD – Inova Fairfax Hopsital
Mohankumar Kurukumbi, MD, FAES – Inova Fairfax Hopstial
Rationale:
The use of medication is preferred in treating epilepsy, however, as established in literature, about 30% of patients develop drug-resistant epilepsy and may require surgical intervention. Laser interstitial thermal therapy (LITT) is the most advanced procedure with the least morbidity to date in combating adult refractory epilepsy in eligible patients. This study aimed to describe temporal lobe (mesial in majority, lateral and anterior in a few) ablation and seizure outcomes following LITT in a single Level 4 epilepsy center over a course of 5 years. Methods:
This is a single-institution retrospective review of twenty patients and their seizure outcomes following LITT for medically intractable temporal lobe epilepsy between January 2019 and August 2024. Demographics, duration of epilepsy, location of epilepsy, pre-ablation and post-ablation seizure frequency data were tracked through the clinical notes from follow-up appointments every three to six months. Engel classification was applied for seizure outcomes every six months after the ablation surgery.
Results:
They were 12 males and 8 females, whose mean age was 40 years. The duration of epilepsy was ranging from 2 to 45 years. Patients were diagnosed for an average duration of 11 years, with the exception of a patient diagnosed for 43 years. 14 had right temporal epilepsy, 4 had left temporal epilepsy, and 2 had multifocal bitemporal epilepsy. 3 of the patients had double ablation, hippocampus and anterior temporal pole. On average, patients experienced 4 seizures per week before the procedure. 6 months after the procedure, improvements were seen with 90% of patients at an Engel 1 classification, described as having no seizures and occasional auras. The percentage of Engel 1 classifications were 64.3% at 12 months, 91% at 24 months, 75% at 36 months, and 100% at 60 months (as shown in the fig). In addition, no patients had symptoms indicating a 3 or 4 Engel classification, demonstrating none had the level of seizures experienced before LITT surgery, regardless of age, sex, right versus left temporal lobe epilepsy.
Conclusions:
In treating refractory temporal epilepsy, it is recommended to utilize the LITT procedure for all qualifying patients, as it has a lower mortality, morbidity and better seizure outcomes.
Funding: None