Abstracts

Rationale: Resection and laser interstitial thermal therapy (LITT) of the localized epileptogenic zone are common surgical treatments for patients with drug-resistant temporal lobe epilepsy (DR-TLE). We aim to examine and compare seizure outcomes after resection or LITT, and to identify clinical and demographic variables associated with seizure outcomes.


Methods: We retrospectively obtained data from 66 patients who received surgical resection (n=29) or LITT (n=37) for DR-TLE from 2011-2022 and were followed for at least two years post-surgery at the University of Pennsylvania. Patient demographics (sex at birth, race), presence of brain MRI or PET lesions, use of intracranial EEG, type and location of the intervention, and 1- and 2-year ILAE outcomes were extracted. The 2-year ILAE outcomes were compared between the two groups using chi-square testing. Logistic regression analysis was used to compare 2-year outcomes against the extracted variables.


Results: Table 1 shows the demographics and laterality of intervention for the resective and LITT cases. Both groups had a similar demographic distribution. Resective cases were predominantly right lateralized (20/29, 69%), while LITT was more often performed on the left (22/37, 59%). Table 2 shows the total counts of ILAE 1 and ILAE 1 or 2 outcomes broken down by specific intervention, lesional status, and preceding intracranial EEG. Resective cases mostly included anterior temporal < ![if !supportAnnotations] >[CK1]< ![endif] > lobectomies (27/29, 93%) and LITT was performed primarily to the mesial temporal structures (32/37, 86%). At 2 years post-surgery, 21/29 (72%) of resective cases and 20/37 (54%) of LITT cases had an ILAE 1 or 2 outcome. While resection trended toward better outcomes, the difference was not significant. A logistic regression analysis demonstrated no significant factors associated with seizure outcomes at 2 years.

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