Journal Club: Is laser therapy effective in temporal lobe epilepsy?

Findings from a retrospective study in 19 children with mesial temporal lobe epilepsy who underwent laser interstitial thermal therapy suggest that the answer to this question is yes. Participants, all of whom were younger than 20 years, had an electroclinical diagnosis of mesial temporal lobe epilepsy along with drug-resistant epilepsy and a history of laser interstitial thermal therapy performed at the investigators’ institution.

Participants were divided into 2 groups: group 1 (nonlesional) included 9 patients with normal brain MRI, and group 2 (lesional) included 10 patients with signs of hippocampal sclerosis on brain MRI. All participants in group 1 and 6 of those in group 2 underwent stereoelectroencephalography.

The Engel Surgical Outcome Scale, using 12-month postsurgical follow-up data, showed that 14 patients (73%) of the entire cohort achieved an Engel 1 score at 12-month follow-up. Specifically, 90% of group 2 and 55.5% of group 1 achieved an Engel 1 score. Investigators observed no complications and noted that a younger age at seizure onset was a predictor of better outcome.

THOUGHTS FROM DR FARBER

Mesial temporal lobe epilepsy is one of the few seizure disorders for which surgery, to remove the scarred area, can be beneficial. Having a closed procedure is, of course, a major benefit and looks to be of great promise here. I also expect it is not technically difficult compared with open surgery.

Reference

Trivedi AM, Montenegro MA, Gonda D, et al. Laser interstitial thermal therapy for the treatment of mesial temporal lobe epilepsy in children. J Child Neurol. 2025;40(5):342-347. doi:10.1177/08830738241312262