Laser thermal ablation in epilepsy.

Introduction:Many different types of surgical procedures are available for patients with drug-resistant epilepsy. MRI-guided laser interstitial thermal therapy is a stereotactic procedure with the potential to provide excellent seizure outcomes, while minimizing surgical approach related complications. Areas covered:This review will cover the role of MRgLITT in the treatment of multiple facets of epilepsy including temporal lobe epilepsy, nodular heterotopias, hypothalamic hamartomas, as well as corpus Callosotomy. Expert opinion:The development of magnetic resonance thermography has advanced continuous monitoring of thermal tissue destruction of pathological tissue in near real-time to allow for individualized neurological care for a person with epilepsy. Overall the results of MRgLITT appear similar to larger open forms of epilepsy surgery though with the promise of a safer side-effect profile. To improve this technique we must develop intraoperative biomarkers of procedural success, and develop tools to improve our patient selection.