HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Stereotactic laser ablation of epileptogenic periventricular nodular heterotopia.

Abstract
Periventricular nodular heterotopia (PVNH) is a neuronal migrational disorder often associated with pharmacoresistant epilepsy (PRE). Resective surgery for PVNH is limited by its deep location, and the overlying eloquent cortex or white matter. Stereotactic MR guided laser interstitial thermal therapy (MRgLITT) has recently become available for controlled focal ablation, enabling us to target these lesions. We here demonstrate the novel application and techniques for the use of MRgLITT in the management of PVNH epilepsy. Comprehensive presurgical evaluation, including intracranial EEG monitoring in two patients revealed the PVNH to be crucially involved in their PRE. We used MRgLITT to maximally ablate the PVNH in both cases. In the first case, seizure medication adjustment coupled with PVNH ablation, and in the second, PVNH ablation in addition to temporal lobectomy rendered the patient seizure free. A transient visual deficit occurred following ablation in the second patient. MRgLITT is a promising minimally invasive technique for ablation of epileptogenic PVNH, a disease not generally viewed as surgically treatable epilepsy. We also show here the feasibility of applying this technique through multiple trajectories and to create lesions of complex shapes. The broad applicability and long term efficacy of MRgLITT need to be elaborated further.
AuthorsYoshua Esquenazi, Giridhar P Kalamangalam, Jeremy D Slater, Robert C Knowlton, Elliott Friedman, Saint-Aaron Morris, Anil Shetty, Ashok Gowda, Nitin Tandon
JournalEpilepsy research (Epilepsy Res) Vol. 108 Issue 3 Pg. 547-54 (Mar 2014) ISSN: 1872-6844 [Electronic] Netherlands
PMID24518890 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2014 Elsevier B.V. All rights reserved.
Topics
  • Adult
  • Electroencephalography
  • Epilepsy (etiology, surgery)
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Laser Therapy (methods)
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Periventricular Nodular Heterotopia (complications)
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: