Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy

Zubkov, Sarah; Bene, Victor A. Del; MacAllister, William S.; Shepherd, Timothy M.; Devinsky, Orrin

doi:10.1016/j.ebcr.2015.07.002

Cited by 62 publications

(22 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A major advantage of SRS in treating intracranial advantage is its avoidance of intraoperative complications. However, it achieves rates of cure in HH cases that appear to be lower than in LITT, and symptomatic postoperative radiation‐related edema is a known risk . Furthermore, the 12‐to 18‐month latency to therapeutic effect would carry consequences relevant to children, potentially limiting the developmental future.…”

Section: Discussionmentioning

confidence: 99%

“…However, it achieves rates of cure in HH cases that appear to be lower than in LITT, and symptomatic postoperative radiation-related edema is a known risk. 39 Furthermore, the 12-to 18-month latency to therapeutic effect would carry consequences relevant to children, potentially limiting the developmental future. It can nevertheless be an effective tool used in conjunction with LITT and other modalities to approach HH pathology.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?

Gandhi

Rekate

et al. 2017

Epilepsia

View full text Add to dashboard Cite

Successful treatment of hypothalamic hamartoma (HH) can result in the resolution of its sequelae including epilepsy and rage attacks. Risks and morbidity of open surgical management of this lesion have motivated the development of laser interstitial thermal therapy (LITT) as a less invasive treatment approach to the disease. Although overall morbidity and risk would appear to be lower, complications related to LITT therapy have been reported, and the longer-term follow-up that is now possible after initial experience helps address the question of whether LITT provides equivalent efficacy compared to other treatment options. We conducted a retrospective analysis of clinical outcomes in eight patients undergoing LITT for HH at our center using the Visualase/Medtronic device. Five patients had refractory epilepsy, one had rage attacks, and two had both. We also compared the published seizure-free outcomes over time and the complication rates for different interventional approaches to the treatment of epilepsy due to HH including open craniotomy, neuroendoscopic, radiosurgical, and radiofrequency approaches. With a mean follow-up of 19.1 months in our series of eight patients, six of seven epilepsy patients achieved seizure freedom, whereas the one patient with rage attacks only did not have improvement of his symptoms. A length of hospital stay of 2.6 days reflects low morbidity and rapid postoperative recuperation with LITT. Considering other reported series and case reports, the overall published seizure freedom rate of 21 of 25 patients is superior to published outcomes of HH cases treated by stereotactic radiosurgery (SRS), craniotomy, or neuroendoscopy, and comparable to radiofrequency ablation. The cumulative experience of our center with other published series supports relatively lower operative morbidity than more invasive approaches and efficacy that is as good or better than open craniotomy procedures and SRS. Although morbidity appears to be lower than other open approaches, complications related to LITT and their avoidance should be considered carefully.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?

Gandhi

Rekate

et al. 2017

Epilepsia

View full text Add to dashboard Cite

show abstract

“…Real tissue damage, however, is produced by ablation and, the risk of permanent neurological deficits should be considered. A prior case report described disabling amnestic syndrome after laser ablation of a hypothalamic hamartoma, resulting from injury to the mammillary bodies in a patient with prior right temporal lobectomy …”

Section: Discussionmentioning

confidence: 99%

“…A prior case report described disabling amnestic syndrome after laser ablation of a hypothalamic hamartoma, resulting from injury to the mammillary bodies in a patient with prior right temporal lobectomy. 15 Case 3 patient has been followed for 19 months. She had one seizure after the procedure which may have been triggered by infection and two other episodes since then, which were brief (prior to surgery, frequency was 1-2 seizures/week).…”

Section: Discussionmentioning

confidence: 99%

Imaging of Laser Therapy in Epilepsy

Nagae

Honce

Nyberg

et al. 2017

Journal of Neuroimaging

View full text Add to dashboard Cite

show abstract

“…Notably, safety was excellent with one patient experiencing an asymptomatic subarachnoid hemorrhage, and with a median length of stay of 1 day. Zubkov et al reported a single case of a disabling amnestic syndrome following laser ablation of a HH in a 19-year old with a prior right temporal lobectomy (118). Post-ablation imaging showed edema in the bilateral mammillary bodies, which likely contributed to the deficit, although the role of the prior lobectomy is uncertain.…”

Section: Clinical Outcomes Using Commercial Mriglittmentioning

confidence: 99%

Stereotactic Laser Ablation for Medically Intractable Epilepsy: The Next Generation of Minimally Invasive Epilepsy Surgery

LaRiviere

Gross

2016

Front. Surg.

View full text Add to dashboard Cite

Epilepsy is a common, disabling illness that is refractory to medical treatment in approximately one-third of patients, particularly among those with mesial temporal lobe epilepsy. While standard open mesial temporal resection is effective, achieving seizure freedom in most patients, efforts to develop safer, minimally invasive techniques have been underway for over half a century. Stereotactic ablative techniques, in particular, radiofrequency (RF) ablation, were first developed in the 1960s, with refinements in the 1990s with the advent of modern computed tomography and magnetic resonance-based imaging. In the past 5 years, the most recent techniques have used MRI-guided laser interstitial thermotherapy (LITT), the development of which began in the 1980s, saw refinements in MRI thermal imaging through the 1990s, and was initially used primarily for the treatment of intracranial and extracranial tumors. The present review describes the original stereotactic ablation trials, followed by modern imaging-guided RF ablation series for mesial temporal lobe epilepsy. The developments of LITT and MRI thermometry are then discussed. Finally, the two currently available MRI-guided LITT systems are reviewed for their role in the treatment of mesial temporal lobe and other medically refractory epilepsies.

show abstract

Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy

Cited by 62 publications

References 19 publications

Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?

Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?

Imaging of Laser Therapy in Epilepsy

Stereotactic Laser Ablation for Medically Intractable Epilepsy: The Next Generation of Minimally Invasive Epilepsy Surgery

Contact Info

Product

Resources

About