John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

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

Illustrations

  • Figure 1
  • Figure 2
Auteurs
1 Division of Pediatric Neurosurgery
2 Division of Pediatric Neurology, BARROW Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
* Correspondence: Manish Ranjan Division of Pediatric Neurosurgery, BARROW Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ, 85016 USA
  • Mots-clés : temporal encephalocele, temporal lobe epilepsy, epilepsy surgery, laser ablation, MRgLITT
  • DOI : 10.1684/epd.2019.1074
  • Page(s) : 265-70
  • Année de parution : 2019

Temporal encephalocele (TE) is a rare but surgically treatable/curable cause of temporal lobe epilepsy (TLE). The surgical intervention varies from local disconnection to extensive anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has evolved as a minimally invasive alternative for intractable epilepsy with good results, however, application of MRgLITT for intractable pediatric epilepsy secondary to TE has not been reported. We present a detailed technical report and clinical experience of MRgLITT in two adolescent children with medically intractable TLE secondary to TE. Pre-surgical evaluation revealed anterior inferior TE with concordant clinico-electrophysiological data. Both the patients underwent MRgLITT after review with the institutional multidisciplinary epilepsy team and discussion with the patient and the family. Both the patients were discharged on post-operative day one and have been seizure-free since the procedure at the last follow-up visit at 18 months and 6 months, respectively. The present series demonstrates first-ever clinical and technical experience of MRgLITT for TE with intractable pediatric epilepsy. The excellent post-operative seizure outcome and favorable postoperative course support MRgLITT as the first line of surgical intervention for TE with intractable TLE and broadens the application of MRgLITT.