Research has suggested that it’s possible to use a new type of laser therapy as a means to help children who have drug-resistant epilepsy. It’s been shown to be safe and effective. The study, which included close to 150 children, resulted in more than half who received the MRI-guided laser interstitial thermal therapy becoming seizure-free at one year.
Dr. Elysa Widjaja said that the results of the study into this new therapy for children show a lot of promise. Dr. Widjaja is a pediatric neuroradiologist at the Hospital for Sick Children. She’s also a professor at the University of Toronto’s Department of Medical Imaging. In addition to being effective, this type of therapy is less invasive than other methods than open epilepsy surgery. It also requires a shorter hospital stay.
This was not the first study that looked into using this type of laser therapy to treat patients. However, previous studies have all been small with only a few participants from a few centers. By expanding the study and collecting data from centers across Canada and the United States, she says that it can help to “Get a better understanding of the outcomes following laser therapy and the complications associated with this type of treatment.”
What Does the Procedure Entail?
The surgeon drills a small hole through the skull and uses MRI guidance to insert a thin laser wire into the center of the lesion. Heat is applied to the brain region that’s affected, ablating the area. This procedure, because it requires only a small hole, is not as invasive, as the doctor said.
Before undergoing therapy in the study, the patients had to undergo MRI and video electroencephalography to isolate the area of the brain where the seizures originate. For this therapy to be successful, the surgeon needs to know the exact part of the brain they need to ablate.
Researchers recruited 182 children from the dedicated registry who were treated with this laser therapy. They were from seven centers in the U.S. and two centers in Canada. The youngest patient in the study was 14 months old, while the oldest patient was 21 years old. The mean age of those involved in the study was 11.2 years old.
All of the patients included in the study had focal epilepsy. This means that the seizures were coming from a defined part of the brain. The patients were also resistant to drug treatment. In these patients, the mean age of seizure onset was 5.4 years old and the mean number of drugs tried was 2.3.
The area of the brain that’s affected can vary from one child to another, which is why they need to be analyzed using MRI and the aforementioned methods.
Out of the 137 patients where one-year seizure outcomes were available, the researchers found that 74 of them were free of seizures, or 54%. There was another meta-analysis conducted that found that the outcome for being seizure-free after undergoing epilepsy surgery was 65%.
Even though the seizure-free rate is higher in patients who undergo epilepsy surgery, Dr. Widjaja says that because the procedure is less invasive and because the hospital stay is much shorter, it makes the procedure more cost-effective. It could be a good solution for many patients. She also said that the procedure works well for reaching deeper areas of the brain where the lesion might be located without the worry of damaging other tissues in the brain.
There is a lot of promise in using this technique for patients who have drug-resistant epilepsy. Although this study was conducted on children, it’s believed that age should not be a factor in the application of this laser therapy.