Interstitial Thermal Therapy in Mesial Temporal Lobe Epilepsy.

Area of Science:

• Neurosurgery
• Epileptology
• Minimally Invasive Procedures

Background:

• Mesial temporal lobe epilepsy (MTLE) is a common form of drug-resistant epilepsy.
• Laser interstitial thermal therapy (LITT) is an emerging surgical option for focal epilepsy.
• Understanding LITT outcomes in MTLE is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate seizure outcomes, procedural results, and safety of LITT in drug-resistant MTLE.
• To assess the impact of LITT on quality of life in MTLE patients.
• To provide data from a large, prospective, multicenter registry.

Main Methods:

• Prospective, multicenter registry (LAANTERN) of adult and pediatric patients with drug-resistant MTLE undergoing LITT.
• Data collected on demographics, epilepsy characteristics, procedural details, seizure outcomes, safety, and quality of life.
• Follow-up up to 5 years, with a focus on 2-year seizure outcomes.

Main Results:

• 145 patients with MTLE underwent LITT, with 77 reaching 2-year follow-up.
• Two-year seizure freedom (Engel 1) achieved in 58.4% of patients.
• LITT was well-tolerated, with mild and transient adverse events in 16.5%.
• Significant improvements in quality of life scores were observed post-procedure.
• Pediatric outcomes were comparable to adult outcomes.

Conclusions:

• LITT is a safe and effective treatment for drug-resistant MTLE.
• The procedure offers clinically meaningful seizure reduction and quality of life improvements.
• LITT should be considered a viable therapeutic option for patients with drug-resistant MTLE.