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Neurosurgeons Couple Innovative Laser Therapy with Epilepsy Surgery

Dr. McKhann Dr. FeldsteinThe 1960s were a dynamic decade, full of social change and technological advancements. One of the great developments to come out of that time was the laser.

Initially depicted as a tool in science fiction stories, the laser turned out to have many practical uses, from reading supermarket bar codes to brain surgery.

Brain surgeons like Dr. Guy McKhann and Dr. Neil Feldstein, from the Epilepsy Center at Columbia University Medical Center/NewYork-Presbyterian Hospital, use lasers to treat tumors and epilepsy with what’s called laser interstitial thermal therapy (LITT).

Dr. McKhann and Feldstein recently used this laser therapy in a unique way to treat a young boy with a severe form of epilepsy. The boy suffered from several seizures a day, despite attempts to control them with medication.

When he was admitted to Columbia with a particularly severe seizure, the neurosurgeons evaluated him and found a large area of abnormal cells in the outer layer of the brain, or cortex. This is typical of patients with a rare form of epilepsy known as focal cortical dysplasia.

Using a variety of tests, the doctors were able to verify that the abnormal area was responsible for the patient’s seizures. The answer to helping the boy lay in eliminating this problem area.

Surgical removal of the part of the brain causing the seizure is a common approach. However, as often happens with focal cortical dysplasia, the entire area did not appear to be easily reached using standard surgical techniques. How to resolve this dilemma?

Dr. McKhann and Feldstein addressed the problem with a combination of surgery, to remove what they could, and LITT to treat the rest. The innovative combination of the newer laser technique and the more established surgical treatment proved to be successful, and the boy’s seizures were largely eliminated.

Dr. McKhann, Dr. Feldstein and former Columbia neurosurgical resident Jason Ellis*, a 2016 Columbia graduate, published the boy’s case and their unique treatment approach in the Journal of Clinical Neuroscience.

Read the article abstract here.

Learn more about Dr. McKhann on his bio page here.
Learn more about Dr. Feldstein on his bio page here.

*Full list of authors: Jason A. Ellis, Juan C. Mejia Munne, Shih-Hsiu Wang, Danielle K. McBrian, Cigdem I. Akman, Neil A. Feldstein, Guy A. McKhann

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