Corpus callosotomy via laser interstitial thermal therapy: a case series

J Neurosurg Pediatr. 2018 Dec 21;23(3):303-307. doi: 10.3171/2018.10.PEDS18368.

Abstract

Corpus callosotomy has been used as a form of surgical palliation for patients suffering from medically refractory generalized seizures, including drop attacks. Callosotomy has traditionally been described as involving a craniotomy with microdissection. MR-guided laser interstitial thermal therapy (MRg-LITT) has recently been used as a minimally invasive method for performing surgical ablation of epileptogenic foci and corpus callosotomy. The authors present 3 cases in which MRg-LITT was used to perform a corpus callosotomy as part of a staged surgical procedure for a patient with multiple seizure types and in instances when further ablation of residual corpus callosum is necessary after a prior open surgical procedure. To the authors' knowledge, this is the first case series of corpus callosotomy performed using the MRg-LITT system with a 3.3-year average follow-up. Although MRg-LITT is not expected to replace the traditional corpus callosotomy in all cases, it is a safe, effective, and durable alternative to the traditional open corpus callosotomy, particularly in the setting of a prior craniotomy.

Keywords: MRg-LITT = MR-guided laser interstitial thermal therapy; OR = operating room; cVEEG = continuous video electroencephalography; corpus callosotomy; drop attacks; epilepsy; laser interstitial thermal therapy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / surgery*
  • Drug Resistant Epilepsy / complications
  • Drug Resistant Epilepsy / drug therapy
  • Drug Resistant Epilepsy / surgery*
  • Epilepsy, Generalized / complications
  • Epilepsy, Generalized / drug therapy
  • Epilepsy, Generalized / surgery*
  • Female
  • Hemispherectomy
  • Humans
  • Infant
  • Laser Therapy / methods*
  • Magnetic Resonance Imaging
  • Magnetic Resonance Imaging, Interventional / methods*
  • Male
  • Robotic Surgical Procedures / methods
  • Syncope / etiology
  • Syncope / surgery*
  • Treatment Outcome
  • Young Adult