TY - JOUR
T1 - Magnetic resonance-guided laser interstitial thermal therapy
T2 - Correlations with seizure outcome
AU - Kang, Joon Y.
AU - Pickard, Allyson A.
AU - Bronder, Jay
AU - Yenokyan, Gayane
AU - Chen, Mo
AU - Anderson, William S.
AU - Sperling, Michael R.
AU - Nei, Maromi
N1 - Publisher Copyright:
© 2021 International League Against Epilepsy
PY - 2021/5
Y1 - 2021/5
N2 - Objective: This study was undertaken to identify clinical factors associated with seizure freedom after magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) in temporal lobe epilepsy patients with unilateral mesial temporal sclerosis (MTS). Methods: We identified 56 patients with magnetic resonance imaging-defined MTS who underwent MRgLiTT with at least 1 year of follow-up. Primary outcome was seizure freedom at 1 year. We examined the association of seizure freedom and the following clinical factors: age at surgery, gender, history of febrile seizures, history of focal to bilateral tonic–clonic seizures, duration of epilepsy at the time of surgery, frequency of interictal epileptiform discharges (IEDs), seizure frequency, and presence of bilateral IEDs. Results: Thirty-five (62.5%) patients were seizure-free at 1 year. The presence of bilateral IEDs and age at surgery were associated with 1-year seizure freedom after MRgLiTT. The presence of bilateral IEDS was associated with lower odds of seizure freedom (odds ratio [OR] =.05, 95% confidence interval [CI] =.01–.46, p =.008), whereas increasing age at surgery was associated with increased odds of seizure freedom (OR = 1.10, 95% CI = 1.03–1.19, p =.009). Significance: This study demonstrates associations between presence of bilateral IEDs and age at surgery and seizure freedom at 1 year after MRgLiTT.
AB - Objective: This study was undertaken to identify clinical factors associated with seizure freedom after magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) in temporal lobe epilepsy patients with unilateral mesial temporal sclerosis (MTS). Methods: We identified 56 patients with magnetic resonance imaging-defined MTS who underwent MRgLiTT with at least 1 year of follow-up. Primary outcome was seizure freedom at 1 year. We examined the association of seizure freedom and the following clinical factors: age at surgery, gender, history of febrile seizures, history of focal to bilateral tonic–clonic seizures, duration of epilepsy at the time of surgery, frequency of interictal epileptiform discharges (IEDs), seizure frequency, and presence of bilateral IEDs. Results: Thirty-five (62.5%) patients were seizure-free at 1 year. The presence of bilateral IEDs and age at surgery were associated with 1-year seizure freedom after MRgLiTT. The presence of bilateral IEDS was associated with lower odds of seizure freedom (odds ratio [OR] =.05, 95% confidence interval [CI] =.01–.46, p =.008), whereas increasing age at surgery was associated with increased odds of seizure freedom (OR = 1.10, 95% CI = 1.03–1.19, p =.009). Significance: This study demonstrates associations between presence of bilateral IEDs and age at surgery and seizure freedom at 1 year after MRgLiTT.
KW - MR-guided LiTT
KW - epilepsy surgery
KW - hippocampal sclerosis
KW - mesial temporal sclerosis
KW - surgery outcomes
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U2 - 10.1111/epi.16872
DO - 10.1111/epi.16872
M3 - Article
C2 - 33713425
AN - SCOPUS:85102458331
SN - 0013-9580
VL - 62
SP - 1085
EP - 1091
JO - Epilepsia
JF - Epilepsia
IS - 5
ER -