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Multicenter study of laser interstitial thermal therapy for mesial temporal lobe epilepsy

Brett Youngerman, MD, MS, Columbia University Irving Medical Center, New York, NY, discusses the options available for patients with temporal lobe epilepsy that are drug resistant, to increase their possibility of achieving seizure freedom. Patients with temporal lobe epilepsy have the option of anterior temporal lobectomy (ATL), an open surgical resection, with 60-80% rates of seizure freedom. Nevertheless, epilepsy surgeries are underutilized, likely due to the concern of risk and invasiveness. Therefore, MRI-guided laser interstitial thermal therapy (laser ablation) is growing in popularity as a minimally invasive alternative to ATL. The most common indication of laser ablation is mesial temporal lobe epilepsy, but data collected to date only consists of single center studies with around 1–2-year follow-ups, resulting in a highly variable reported rate of seizure freedom and unknown long-term durability. Dr Youngerman explains that his team set out to perform a multi-center retrospective cohort study. Their key findings included that at a median follow-up of over 4 years, half of the patients remained seizure free. Importantly, laser ablation is an option for patients who prefer minimally invasive procedures, reducing barriers to patients undergoing surgery. Another key finding was that patients who chose laser ablation could still be candidates for ATL. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.