Outcome after laser interstitial thermal therapy (LITT) in patients with drug-resistant epilepsy (P2-1.002)

Abstract

<h3>Objective:</h3> To investigate the outcome of seizure freedom among patients with DRE who underwent LITT for temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) and identify factors contributing to seizure recurrence after LITT. <h3>Background:</h3> Surgical resections offer the highest chance for seizure freedom for patients with drug-resistant epilepsy (DRE); however, over the last few years, there has been increased interest in exploring more minimally invasive surgical techniques, such as laser interstitial thermal therapy (LITT). <h3>Design/Methods:</h3> This retrospective chart review included patients who underwent LITT from 2015–2021. We collected data on demographics, clinical history, presurgical testing, postoperative complications, and seizure freedom outcomes at various time points. We conducted t-tests and Fisher’s exact tests to compare the percentages of seizure freedom for each factor of interest and a linear regression to determine whether these factors are strong predictors of seizure recurrence. <h3>Results:</h3> 19 out of 29 patients (65.5%) were seizure free one year after LITT and 13/29 (44%) were seizure free at the last visit (mean FU duration = 49.5 months). Seizure freedom was 50% (12/24) among the TLE group and 20% (1/5) among the ETLE group at the last visit (p=0.343). Five patients (17%) had acute post-operative complications, which were reversible. Two patients (7%) reported memory and comprehension impairments. Gender, family history of epilepsy, handedness, etiology, and epilepsy duration were not significantly associated with seizure recurrence. Six patients underwent a re-operation, with five anterior temporal lobectomies and one additional ablation. Three of the ATL patients were seizure free after the operation, but the additional ablation did not result in seizure freedom. <h3>Conclusions:</h3> LITT can potentially offer seizure freedom to carefully selected patients with DRE. Our study showed the TLE group had higher proportions of patients with seizure freedom in comparison to the ETLE group, but it was not statistically significant given the small sample size. <b>Disclosure:</b> Ms. In has nothing to disclose. Dr. El Refaey has nothing to disclose. The institution of Dr. Castellano has received research support from NIH. Mark Richardson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SetPoint Medical. Mark Richardson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Mark Richardson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Mark Richardson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AskBio. Mark Richardson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Voyager Therapeutics. Dr. Bagic has nothing to disclose. Dr. Barot has nothing to disclose.