Drug‐resistant focal epilepsy (DRFE), defined by failure of two antiepileptic drugs, affects 30% of epileptic patients. Epilepsy surgeries are alternative options for this population. Preoperative evaluation is critical to include potential candidates, and to choose the most appropriate procedure to maximize efficacy and simultaneously minimize side effects. Traditional procedures involve open skull surgeries and epileptic focus resection. Alternatively, neuromodulation surgeries use peripheral nerve or deep brain stimulation to reduce the activities of epileptogenic focus. With the advanced improvement of laser‐induced thermal therapy (LITT) technique and its utilization in neurosurgery, magnetic resonance‐guided LITT (MRgLITT) emerges as a minimal invasive approach for drug‐resistant focal epilepsy. In the present review, we first introduce drug‐resistant focal epilepsy and summarize the indications, pros and cons of traditional surgical procedures and neuromodulation procedures. And then, focusing on MRgLITT, we thoroughly discuss its history, its technical details, its safety issues, and current evidence on its clinical applications. A case report on MRgLITT is also included to illustrate the preoperational evaluation. We believe that MRgLITT is a promising approach in selected patients with drug‐resistant focal epilepsy, although large prospective studies are required to evaluate its efficacy and side effects, as well as to implement a standardized protocol for its application.
Potential surgical therapies for drug‐resistant focal epilepsy
Wei Shan,Xue-Xia Mao,Xiu Wang,R. Hogan,Qun Wang
Published 2021 in CNS Neuroscience & Therapeutics
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- Publication year
2021
- Venue
CNS Neuroscience & Therapeutics
- Publication date
2021-06-07
- Fields of study
Medicine
- Identifiers
- External record
- Source metadata
Semantic Scholar, PubMed
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