Abstracts

Rationale: Corpus callosotomy is a palliative treatment for Lennox Gastuat syndromes (LGS) with disabling tonic, atonic and myoclonic seizures. However, traditional corpus callosotomy carries the risk for surgical complication associated with craniotomy. Here, we report two successful cases of stereotactic laser ablation of anterior corpus callosotomy, which achieved a comparable surgical outcome to that of traditional open surgery without surgical complications. Methods: Minimally invasive anterior corpus callosotomy was performed using stereotactic MRI-guided laser interstitial laser thermal therapy (LITT). A laser fiber was placed from a right frontal trajectory to ablate the anterior genu of the corpus callosum. A second laser fiber was implanted from a right parieto-occipital trajectory along the longitudinal axis of the corpus callosum to ablate the main body of corpus callosum. A total of 3-4 ablations were performed to disconnect 60-70% of anterior corpus callosum. Results: Two patients (25 and 45 years of age) with medically intractable LGS underwent stereotactic laser ablation of anterior corpus callosotomy. Adequate ablation of anterior corpus callosotomy was confirmed by postoperative MRI diffuse tensor imaging (DTI). Marked reduction in frequency and duration of paroxysmal fast activity was observed during post-operative video-EEG study comparing to pre-operative video-EEG study. Freedom from disabling seizures was achieved post-operatively for 2 months in one patient and 16 months in another without experiencing surgical complications. Conclusions: These are the first reported successful cases of anterior corpus callosotomy using MRI-guided LITT, which raise the possibility that LITT might be a safe and effective alternative to traditional corpus callosotomy. Funding: None