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Long‐term seizure and psychiatric outcomes following laser ablation of mesial temporal structures

Epilepsia Feb 12, 2022

Laser interstitial thermal therapy (LiTT) for the management of drug-resistant mesial temporal lobe epilepsy (MTLE) has postsurgical seizure outcome limited to 2 years. Researchers herein investigated seizure outcome changes over a period ranging from 18 to 81 months and determined the seizure-free rate in the last follow-up year. Further, they determined the variables linked with seizure freedom and assessed how LiTT affects pre-surgical mood and anxiety disorders.

  • By performing a retrospective review of the medical records of patients who underwent LiTT for MTLE at the University of Miami Comprehensive Epilepsy Center, researchers identified 48 patients (mean age = 43 ± 14.2 years) for inclusion who were followed for a mean period of 50 ± 20.7 months.

  • There were 29 patients (60.4%) who achieved a seizure-free (Engel Class I) outcome, whereas 11 patients (22.9%) had one to three seizures/year.

  • Among patients with 24- and > 61-month follow-up periods, there was a decrease in seizure-freedom rate from 77.8% to 50%, respectively.

  • There were 83% of all patients who were seizure-free in the last follow-up year.

  • Having mesial temporal sclerosis (MTS), no pre-surgical focal to bilateral tonic–clonic seizures, and no psychopathology in the last follow-up year were noted to be linked with seizure freedom.

  • For treatment-resistant MTLE, LiTT seems to be a safe and effective surgical option, especially among patients with MTS.

  • LiTT can also result in remission of pre-surgical mood and anxiety disorders.

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