A developing new laser surgical technique for epilepsy appears to be safe and effective and reduces hospital stays to one or two days, according to two research reports presented today during the American Epilepsy Society 66th Annual Meting at the San Diego Convention Center. Both studies were conducted on pediatric patients with refractory focal seizures. Investigators reported the laser technique which requires only a small scalp incision and twist drill hole in the skull to be more precise and with fewer complications than conventional resective surgery. The laser system is already FDA cleared for neurosurgery.
Five patients between ages 11 and 18 underwent laser ablation surgery at Miami Children's Hospital between May 2011 and June 2012. Two patients, one of whom required a second ablation, were seizure free after surgery, and another patient's seizures were decreased. Of the two remaining patients, one became seizure free following conversion to conventional resection, while the other was little improved. (Abstract #1.287)
According to Ian Miller, M.D., Director of Neuroinformatics at Miami Children's Hospital, "The biggest factor determining success was precise placement of the laser fiber, and complete ablation of the epileptogenic zone. Small deep lesions such as those seen in tuberous sclerosis may be particularly amenable to this approach."
In a similar study conducted by a research team at the Sutter Medical Center, Sacramento, and the Epilepsy and Biomagnetic Imaging Centers at the University of California San Francisco, four pediatric patients with intractable seizures between ages 8 and 19 underwent laser ablation surgery between November 2011 and June 2012. All four were pain free, eating and ambulatory six to eight hours after surgery and discharged in less than 24 hours. Seen several weeks post-operatively, three of the four patients were seizure free. For the fourth patient, who has a complex genetic disorder, seizures were reduced from four per day to one per week. (Abstract #1.278)
"Laser ablation may offer an attractive option for destroying deep non-mesial temporal and non-lesional foci with minimal risk and invasiveness," said Michael G. Chez, M.D., Director of Pediatric Neurology at the Sutter Medical Center. "However, more studies are needed to demonstrate its long-term efficacy and potential to reduce the burden of anticonvulsant drugs."