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September 28, 2022 9:06 AM
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MRI-Guided Laser Therapy

Epilepsy is a condition that causes abnormal brain activity, called a seizure. A seizure is a period of abnormal behavior, sensations, or a loss of awareness of one’s surroundings. Medications are the first line of treatment, but if they do not work, surgery might be recommended. MRI-guided laser therapy is effective in reducing or eliminating seizures in some people.

What Is Epilepsy?

Seizures come in many forms. It takes at least two seizures at least 24 hours apart to be diagnosed with epilepsy. Sometimes seizures can be triggered by something like an illness or head trauma and go away after a time.

Many types of seizures exist, and you might be diagnosed with:

  • Simple partial seizures
  • Complex partial seizures
  • Absence seizures
  • Tonic seizures
  • Atonic seizures
  • Clonic seizures
  • Myoclonic seizures
  • Tonic-clonic seizures

The symptoms vary according to the area of the brain that is affected. Your physician might use several tests to diagnose the type of seizure you have, such as an electroencephalogram (EEG), magnetic resonance imagery (MRI), and lab work. Most of the time, medications are the first treatment option that is tried to make the seizures go away.

When medications do not reduce the seizures, and they are persistent or debilitating, surgery might be an option. Many types of brain surgery for seizures exist. Most of them involve open brain surgery where a small opening in the skull is created, and tissue is removed. MRI-guided laser ablation is a relatively new option that is less invasive and has had proven success in eliminating seizures for many people.

How Does MRI-Guided Laser Therapy Work?

MRI-guided laser therapy, sometimes called laser ablation therapy, is a procedure where an MRI is used to image the brain to find any abnormalities. Once the brain section where the seizures arise has been located, a laser is used to eliminate that brain tissue. It is more accurate than traditional open brain surgery, but it is not appropriate for everyone.

The most common use of laser ablation therapy is for those who have small lesions that can be removed with minimally invasive techniques. The lesion must be in a non-critical portion of the brain and is usually a result of scar tissue. It is reserved for people who have a clearly defined area of the brain where seizures arise.

The procedure is carried out under general anesthesia. A small hole is created in the brain. Next, a small (2 mm) tube with a laser probe is guided through the small hole to the area of the seizure focus. The laser is used to destroy the tissue that is causing the problem.

What Results Can You Expect?

During the procedure, magnetic resonance imagery is used to guide the laser to pinpoint the exact area of tissue that needs to be removed. The MRI helps to position the laser and monitor the heat of the laser so that it is in the correct area to be eliminated. A computer monitors the temperature where the laser is placed to help protect the surrounding brain tissue.

One of the main advantages is that it is a shorter procedure and is minimally invasive. It often requires a shorter hospital stay and often produces fewer side effects. Many people experience only a small amount of discomfort after the procedure and only need to stay in the hospital for one or two days. Some people might experience a headache for a short time, but this typically resolves quickly, and the person can usually return to normal activities within three to seven days.

Early data on laser surgery indicates that over half of the people who underwent it were free from seizures two years later. It has been proven effective in mesial temporal lobe epilepsy (MTLE), which is the most common type of focal epilepsy. The procedure has been used to treat other types of focal seizures with great success.

MRI-guided laser surgery for those who have epilepsy that is unresponsive to medications can benefit from this minimally invasive procedure. In most cases, they can expect good results and at least some relief from seizures. This procedure has significant advantages over conventional surgery for those who are candidates.

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