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LITT in Pediatric Epilepsy

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Laser Interstitial Thermal Therapy in Neurosurgery

Abstract

MRgLITT was first used for treatment of epilepsy in a child in 2010. Since that initial case, the technique has been applied to many pediatric epileptogenic targets such as tuberous sclerosis, mesial temporal lobe epilepsy, focal cortical dysplasia, periventricular nodular heterotopia, insular epilepsy, cavernous malformation, and, most efficiently, hypothalamic hamartoma. The combination of instant thermal ablation and peri-operative steroids to combat edema has resulted in an 83% 1-year seizure freedom rate with 1.5% rate of memory impairment, making it a profound improvement on open surgery. The technique has also been applied in disconnection, such as in corpus callosotomy, both in de novo and in salvage cases. In the treatment of drop attacks, three to four lasers can be employed to achieve the disconnection minimally invasively, obviating the need for a craniotomy. Outside of hypothalamic hamartoma, there have been few large pathology-based series, and long-term cognitive data is not available. MRgLITT in pediatric epilepsy holds the promise of less morbidity and shorter hospital stays, steps that may narrow the treatment gap in pediatric epilepsy surgery from anxiety and morbidity avoidance.

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Author information

Authors and Affiliations

  1. Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA

    Sara Hartnett

  2. Department of Neurosurgery, Section of Pediatric Neurosurgery, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA

    Daniel J. Curry

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  1. Sara Hartnett
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  2. Daniel J. Curry
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Correspondence to Daniel J. Curry .

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Editors and Affiliations

  1. Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA

    Veronica L. Chiang

  2. Department of Neurosurgery, Rutgers-RWJ Medical School, New Brunswick, NJ, USA

    Shabbar F. Danish

  3. Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA

    Robert E. Gross

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Hartnett, S., Curry, D.J. (2020). LITT in Pediatric Epilepsy. In: Chiang, V., Danish, S., Gross, R. (eds) Laser Interstitial Thermal Therapy in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-48047-9_11

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