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

A retrospective study in 19 children with mesial temporal lobe epilepsy who underwent laser interstitial thermal therapy suggests that the answer to this question is “yes.” Participants, all of whom were younger than 20, 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 magnetic resonance imaging (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. This represents a full 90% of group 2, who achieved an Engel 1 score, as did 55.5% of group 1. 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 expect it also 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