دورية أكاديمية
Magnetic resonance imaging-guided stereotactic laser ablation therapy for the treatment of pediatric epilepsy: a retrospective multiinstitutional study.
| العنوان: | Magnetic resonance imaging-guided stereotactic laser ablation therapy for the treatment of pediatric epilepsy: a retrospective multiinstitutional study. |
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| المؤلفون: | Arocho-Quinones EV; Departments of1Neurosurgery and.; Departments of1Neurosurgery and.; 3Department of Neurosurgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin., Lew SM; Departments of1Neurosurgery and.; 3Department of Neurosurgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin., Handler MH; 4Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado., Tovar-Spinoza Z; 5Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York., Smyth MD; 6Division of Neurosurgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida., Bollo RJ; 7Department of Neurosurgery, Primary Children's Hospital, Salt Lake City, Utah., Donahue D; Departments of8Neurosurgery and., Perry MS; 9Neurology, Cook Children's Medical Center, Fort Worth, Texas., Levy M; 10Department of Neurosurgery, Rady Children's Hospital San Diego, San Diego, California., Gonda D; 10Department of Neurosurgery, Rady Children's Hospital San Diego, San Diego, California., Mangano FT; 11Department of Neurosurgery, Cincinnati Children's Hospital, Cincinnati, Ohio., Kennedy BC; 12Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Storm PB; 12Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Price AV; 13Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas., Couture DE; 14Department of Neurosurgery, Wake Forest Baptist Health, Winston-Salem, North Carolina., Oluigbo C; 15Department of Neurosurgery, Children's National Health System, Washington, DC., Duhaime AC; 16Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts., Barnett GH; 17Department of Neurosurgery, Cleveland Clinic Children's, Cleveland, Ohio., Muh CR; 18Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.; 24Department of Neurosurgery, Maria Fareri Children's Hospital, Valhalla, New York., Sather MD; 19Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania., Fallah A; 20Department of Neurosurgery, UCLA Mattel Children's Hospital, Los Angeles, California., Wang AC; 20Department of Neurosurgery, UCLA Mattel Children's Hospital, Los Angeles, California., Bhatia S; 21Department of Neurosurgery, Nicklaus Children's Hospital, Miami, Florida., Eastwood D; 22Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin., Tarima S; 22Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin., Graber S; 4Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado., Huckins S; 5Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York., Hafez D; 23Department of Neurosurgery, St. Louis Children's Hospital, St. Louis, Missouri; and., Rumalla K; 23Department of Neurosurgery, St. Louis Children's Hospital, St. Louis, Missouri; and., Bailey L; Departments of8Neurosurgery and., Shandley S; Departments of8Neurosurgery and., Roach A; 11Department of Neurosurgery, Cincinnati Children's Hospital, Cincinnati, Ohio., Alexander E; 12Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Jenkins W; 14Department of Neurosurgery, Wake Forest Baptist Health, Winston-Salem, North Carolina., Tsering D; 15Department of Neurosurgery, Children's National Health System, Washington, DC., Price G; 16Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts., Meola A; 17Department of Neurosurgery, Cleveland Clinic Children's, Cleveland, Ohio., Evanoff W; 17Department of Neurosurgery, Cleveland Clinic Children's, Cleveland, Ohio., Thompson EM; 18Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina., Brandmeir N; 19Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania. |
| مؤلفون مشاركون: | Pediatric Stereotactic Laser Ablation Workgroup |
| المصدر: | Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2023 Mar 03, pp. 1-14. Date of Electronic Publication: 2023 Mar 03. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 101463759 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1933-0715 (Electronic) Linking ISSN: 19330707 NLM ISO Abbreviation: J Neurosurg Pediatr Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Charlottesville, VA : American Association of Neurological Surgeons, 2004- |
| مستخلص: | Objective: The authors of this study evaluated the safety and efficacy of stereotactic laser ablation (SLA) for the treatment of drug-resistant epilepsy (DRE) in children. Methods: Seventeen North American centers were enrolled in the study. Data for pediatric patients with DRE who had been treated with SLA between 2008 and 2018 were retrospectively reviewed. Results: A total of 225 patients, mean age 12.8 ± 5.8 years, were identified. Target-of-interest (TOI) locations included extratemporal (44.4%), temporal neocortical (8.4%), mesiotemporal (23.1%), hypothalamic (14.2%), and callosal (9.8%). Visualase and NeuroBlate SLA systems were used in 199 and 26 cases, respectively. Procedure goals included ablation (149 cases), disconnection (63), or both (13). The mean follow-up was 27 ± 20.4 months. Improvement in targeted seizure type (TST) was seen in 179 (84.0%) patients. Engel classification was reported for 167 (74.2%) patients; excluding the palliative cases, 74 (49.7%), 35 (23.5%), 10 (6.7%), and 30 (20.1%) patients had Engel class I, II, III, and IV outcomes, respectively. For patients with a follow-up ≥ 12 months, 25 (51.0%), 18 (36.7%), 3 (6.1%), and 3 (6.1%) had Engel class I, II, III, and IV outcomes, respectively. Patients with a history of pre-SLA surgery related to the TOI, a pathology of malformation of cortical development, and 2+ trajectories per TOI were more likely to experience no improvement in seizure frequency and/or to have an unfavorable outcome. A greater number of smaller thermal lesions was associated with greater improvement in TST. Thirty (13.3%) patients experienced 51 short-term complications including malpositioned catheter (3 cases), intracranial hemorrhage (2), transient neurological deficit (19), permanent neurological deficit (3), symptomatic perilesional edema (6), hydrocephalus (1), CSF leakage (1), wound infection (2), unplanned ICU stay (5), and unplanned 30-day readmission (9). The relative incidence of complications was higher in the hypothalamic target location. Target volume, number of laser trajectories, number or size of thermal lesions, or use of perioperative steroids did not have a significant effect on short-term complications. Conclusions: SLA appears to be an effective and well-tolerated treatment option for children with DRE. Large-volume prospective studies are needed to better understand the indications for treatment and demonstrate the long-term efficacy of SLA in this population. |
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| فهرسة مساهمة: | Keywords: drug-resistant epilepsy; functional neurosurgery; laser interstitial thermal therapy; magnetic resonance imaging–guided stereotactic laser ablation; minimally invasive technique; pediatric epilepsy; seizure focus |
| تواريخ الأحداث: | Date Created: 20230308 Latest Revision: 20240216 |
| رمز التحديث: | 20240216 |
| مُعرف محوري في PubMed: | PMC10193482 |
| DOI: | 10.3171/2022.12.PEDS22282 |
| PMID: | 36883640 |
| قاعدة البيانات: | MEDLINE |
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