Systematic review of corpus callosotomy utilizing MRI guided laser interstitial thermal therapy. (June 2020)

• Record Type: Journal Article
• Authors: Badger, Clint A.; Lopez, Alejandro J.; Heuer, Gregory; Kennedy, Benjamin C.
• Is Part Of: Journal of clinical neuroscience. Volume 76(2020)
• Page Start: 67
• Page End: 73
• Publication Date: 2020-06
• Subjects: GTC Generalized tonic-clonic -- CC Corpus callosotomy -- EEG Electroencephalography -- MRI Magnetic resonance imaging -- MRgLITT MRI-guided Laser interstitial thermal therapy -- VNS Vagal nerve stimulation -- CPS Complex partial seizure -- AED Antiepileptic drug -- LGS Lennox-Gastaut syndrome -- GPFA Generalized periodic fast activity -- POD Post-operative day -- SMA Supplementary motor area -- LITT Laser interstitial thermal therapy; Ablation -- Stereotactic -- Epilepsy -- Atonic -- Callosotomy -- Laser; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.046
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Corpus callosotomy reduces the rate of atonic seizures. LITT is a minimally-invasive alternative to open callosotomy. A complete callosotomy can be accomplished with LITT. Larger samples sizes are needed to determine seizure outcome after LITT. Abstract: Corpus callosotomy is a palliative surgical option for patients with refractory epilepsy and frequent drop attacks, decreasing seizure frequency and severity by disconnecting the cerebral hemispheres. Though often successful, open surgery is not without risk. Corpus callosotomy by MRI-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive alternative to the standard open procedure. This report aims to present an illustrative case and systematically review the current literature on the surgical technique. A systematic review of the English literature through January 2019 was performed. Articles were searched by title utilizing the following key word combinations: "laser" and "callosotomy", "callosotomy" and "ablation", "laser" and "corpus", "callosotomy" and "thermal", and "stereotactic" and callosotomy". The articles recovered were then classified by level of evidence and summarized. Fifteen papers were reviewed, of which 6 met inclusion and exclusion criteria. All included studies were classified as level IV evidence. There was a total of 13 patients ranging from 13 months to 44 years old (mean 23.5 years old). The number of laser fibers utilized ranged from 1 to 3. Engel class I was achieved in 5 patients, II in 4, III in 2, IV in 1. Reported patient follow up was 4–39.7 months (mean 15.43). Corpus callosotomy utilizing MRI-guided laser interstitial thermal therapy results in improvement in seizure frequency and severity with minimal complications. Prospective trials are needed to compare its seizure control and long-term outcomes to that of standard open callosotomy.