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Temporal encephalocele: a novel indication for magnetic resonance-guided laser interstitial thermal therapy for medically intractable epilepsy Volume 21, issue 3, June 2019

TEST YOURSELF

(1) Is minimal resection or minimally invasive surgery for temporal encephalocele with intractable epilepsy effective?

(2) What is the rationale for choosing MRgLITT to treat temporal encephalocele with intractable epilepsy?

 

 

 

 

 

 

 

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Answers

(1) Traditionally, temporal encephalocele with intractable epilepsy has been treated with open surgery and the extent of resection has varied from local disconnection to extensive temporal lobectomy and amygdalohippocampectomy. The surgical outcome is excellent irrespective of the approach in the literature, and this was the case for our surgical series based on the treatment of temporal encephalocele with MRgLITT. Our experience and the evolving overall experience suggest effectiveness with minimal resection, and with technological advancement, the MRgLITT may achieve excellent and comparable results with minimal required access, avoiding major open surgery.

 

(2) The rationale for MRgLITT to treat temporal encephalocele is disconnection, which is similar in approach to MRgLITT for hypothalamic hamartoma. It is not important to target and ablate the encephalocele per se but to target the “stem” and surrounding cortex, to disconnect the “epileptogenic” area from the rest of the temporal lobe.

 

 

 

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