Laser Interstitial Thermal Therapy versus Open Surgery for Mesial Temporal Lobe Epilepsy: A Systematic Review and Meta-Analysis

Epilepsy surgery offers a vital treatment option for drug-resistant mesial temporal lobe epilepsy, with temporal lobe resection (TLR) and magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) being fundamental interventions. This meta-analysis specifically examines seizure outcomes...

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Bibliographic Details
Published in:World neurosurgery 2024-12, Vol.192, p.224-235.e15
Main Authors: Ekman, Felix R., Bjellvi, Johan, Ljunggren, Sofia, Malmgren, Kristina, Nilsson, Daniel
Format: Article
Language:English
Subjects:
Drug Resistant Epilepsy - surgery
Epilepsy, Temporal Lobe - surgery
Humans
Laser Therapy - adverse effects
Laser Therapy - methods
Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT)
Mesial temporal lobe epilepsy (mTLE)
Neurosciences
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - methods
Neurovetenskaper
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Seizure outcomes
Surgical complications
Temporal lobe resection (TLR)
Treatment Outcome
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Summary:Epilepsy surgery offers a vital treatment option for drug-resistant mesial temporal lobe epilepsy, with temporal lobe resection (TLR) and magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) being fundamental interventions. This meta-analysis specifically examines seizure outcomes at extended follow-up periods exceeding 24 months, visual field deficits as measured by perimetry, and complication rates both overall and categorized based on duration as minor (transient 6 months) to inform clinical decision-making. For seizure freedom, TLR was superior, with 72.5% [65.6%, 78.5%] of patients achieving postoperative seizure freedom compared to 57.1% [51.2%, 62.7%] for MRgLITT (P value
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2024.09.090