A new minimally invasive laser-based tool for epilepsy surgery offers a quicker recuperation time for patients than major surgery, Mayo Clinic researchers report. The research is ongoing, but preliminary results were recently presented at the American Academy of Neurology.
For more than 50 years, the standard effective treatment for medication-resistant epileptic seizures has been brain surgery. Neurosurgeons remove a small circle of the skull and probe into the brain to cut out or isolate the area where seizures are occurring. The operation, known as a temporal lobectomy, is effective in up to 80 percent of patients when the seizures are localized. The recuperation period can be lengthy, involving several days in the hospital and one to three months for the patient to return to ordinary activities.
This new technique, which is available at Mayo Clinic's Rochester and Jacksonville, Fla., campuses (and will soon be available at Mayo Clinic in Arizona), offers significant potential, says co-author W. Richard Marsh, M.D., a Mayo Clinic neurosurgeon.
"We continue to investigate this new minimally invasive technique that could change how epilepsy surgery is done," Dr. Marsh says.
Although approximately 14 patients (eight in Rochester, six in Jacksonville) have undergone this treatment to date, the research team reported positive preliminary results on their first five patients in Rochester -- all of whom had epilepsy involving highly localized seizures occurring in the hippocampus. The most dramatic difference was the recuperation time: Patients required only one night in the hospital and were back to their daily activities in a week.
In an MRI-equipped suite, patients were placed under general anesthesia in a stereotactic frame. Creating a small burr hole in the back of the skull, researchers directed the laser-tipped catheter to the hippocampus to burn a tiny lesion at the site of the seizures. An intraoperative MRI scan verified the location and another MRI scan after the procedure confirmed the extent of the lesion.