Dr. Guy McKhann from the Epilepsy Center has broken new ground at Columbia University/New York Presbyterian Hospital. He is the first neurosurgeon to use the institute’s new Visualase, Inc. MRI-Guided Laser Technology on a patient with epilepsy.
Dr. McKhann’s patient had a form of epilepsy called mesial temporal sclerosis (MTS), which is one of the most common causes of epilepsy that can be treated by surgery. The patient’s seizures were originating deep in the temporal lobe due to a combination of scarring and loss of neurons. Treatment of this condition is usually via an open resective surgery: the part of the brain containing the region where the seizures start is removed.
Instead of surgically removing the targeted area of the brain, Dr. McKhann used this new technology to pinpoint the scarred area with a beam of light energy. Through a small hole in the skull, a laser was placed into the area of seizure onset. Under real time MRI guidance, the laser was used to create a thermal lesion to destroy the seizure onset zone. Because the laser probe is so small (less than 2 mm in diameter), this approach is much less invasive and may be safer than traditional epilepsy surgery. The patient was discharged home the day after surgery and is recovering well.
Many epilepsy surgery patients may be candidates for this new technology, including patients with MTS, hypothalamic hamartoma, or other types of focal onset, well localized epilepsy. Laser therapy is also able to target deep seated brain tumors with high precision and few side effects.
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