Revisiting Focused Ultrasound Surgery for Epilepsy (ReFUSE)
Abstract number :
1.336
Submission category :
9. Surgery / 9C. All Ages
Year :
2021
Submission ID :
1826355
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Vibhor Krishna, MD - University of North Carolina at Chapel Hill; Keiichi Abe – Tokyo Women's Medical University; Kambiz Alavian – Imperial College London; Toba Niazi – Nicklaus Children's Hospital; Carlos Sanchez – Children's National Hospital; John Ragheb – Nicklaus Children's Hospital; Toshio Yamaguchi – Shinyurigaoka General Hospital; Shelly Wang – Nicklaus Children's Hospital; Takaomi Tiara – Tokyo Women's Medical University; Travis Tierney – Imperial College London
Rationale: We demonstrate the first use of an incisionless, radiation-free method to treat pharmacoresistant epilepsy in humans.
Methods: Transcranial focused ultrasound thermoablation was used to target an epileptic focus or the anterior nucleus of the thalamus. Thermoablation was monitored in real time using magnetic resonance phase thermographic methods. Surgeries were performed either under general anesthesia (epileptic focus) or without sedation (anterior nucleus) in accordance with the Declaration of Helsinki, patient consent and local institutional review board approval.
Results: The first two patients harbored hypothalamic hamartomas causing gelastic seizures that did not generalize. The other patients with complex partial seizures either had no lesion or did not wish to undergo invasive lesional surgery. Transcranial focused ultrasound was used to target the hypothalamic hamartoma, the anterior nucleus of the thalamus or a localized epileptogenic zone. Durable seizure control followed ultrasonic surgery without severe neurological, endocrine or cognitive complications. All patients were discharged from the hospital within 2 postoperative days.
Conclusions: Focused ultrasound surgery is an inexpensive, safe and potentially highly effective method to treat pharmacoresistant epilepsy.
Funding: Please list any funding that was received in support of this abstract.: The Focused Ultrasound Foundation of Virginia (Grant no.: 530 to TST and VK). No commercial support. None of the authors declare any in-kind or financial conflict of interest.
Surgery