Laser Ablation of a Nonlesional Cingulate Gyrus Epileptogenic Zone Using Robotic-Assisted Stereotactic EEG
Pavan S Upadhyayula1, Robert C Rennert1, Reid Hoshide1
1Department of Neurosurgery, University of California San Diego, San Diego, California, USA.
Background:
Nonlesional cingulate gyrus epilepsy is rare, difficult to diagnose, and challenging to treat.
Methods:
We report the use of ROSA (Medtech Surgical, Inc., New York, NY, USA) robotic assistance for stereotactic EEG (S-EEG) localization and therapeutic thermal laser ablation of a nonlesional cingulate gyrus epileptogenic zone in a 17-year-old female with intractable partial epilepsy.
Results:
After an inconclusive exhaustive initial workup, robotic-assisted S-EEG localized the patient's seizure focus to the right cingulate gyrus. Robotic-assisted lesioning of the cingulate gyrus was performed via 5 total ablations with 3 minimally invasive catheters. There were no perioperative complications. The patient was discharged home on postoperative day 2 at her neurologic baseline. She was seizure free for 8 months postoperatively, with a sustained partial response through the 23-month follow-up.
Conclusions:
This report expands the technical uses, pathologies, and patient populations being treated via robotic-assisted neurosurgery.
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