Magnetic Resonance-Guided Laser Interstitial Thermal Therapy (MR-gLiTT) in Pediatric Epilepsy Surgery: State of the Art and Presentation of Giannina Gaslini Children's Hospital (Genoa, Italy) Series.

Alessandro Consales,Mattia Pacetti,Erica Cognolato,Lino Nobili,Giuseppe Di Perna,Domenico Tortora,Gianluca Piatelli,Maria Margherita Mancardi

doi:10.3389/fneur.2021.739034

Abstract

Magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT) is a novel minimally invasive treatment approach for drug-resistant focal epilepsy and brain tumors. Using thermal ablation induced by a laser diode implanted intracranially in a stereotactic manner, the technique is highly effective and safe, reducing the risk associated with more traditional open surgical approaches that could lead to increased neurological morbidity. Indications for MR-gLiTT in pediatric epilepsy surgery include hypothalamic hamartoma, tuberous sclerosis complex, cavernoma-related epilepsy, SEEG-guided seizure onset zone ablation, corpus callosotomy, periventricular nodular heterotopia, mesial temporal lobe epilepsy, and insular epilepsy. We review the available literature on the topic and present our series of patients with drug-resistant epilepsy treated by MR-gLiTT. Our experience, represented by six cases of hypothalamic hamartomas, one case of tuberous sclerosis, and one case of dysembryoplastic neuroepithelial tumor, helps to confirm that MR-gLiTT is a highly safe and effective procedure for several epilepsy conditions in children.

Highlights

Magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT) is a novel and very promising minimally invasive therapeutic approach in the field of neurosurgery
We report on the state of the art on the use of MRgLiTT in pediatric epilepsy surgery
The authors stated that laser ablation represents a minimally invasive alternative to resective epilepsy surgery and is an effective treatment for refractory epilepsy due to cortical tubers [22]

Summary

Introduction

Magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT) is a novel and very promising minimally invasive therapeutic approach in the field of neurosurgery. The authors stated that laser ablation represents a minimally invasive alternative to resective epilepsy surgery and is an effective treatment for refractory epilepsy due to cortical tubers [22].

Results

Conclusion