A brain laser may sound like the stuff of science fiction, but it’s actually a promising new option for some epilepsy patients, especially those who are too sick to tolerate other surgical treatments. If drug therapy doesn’t control your epilepsy and you have other health problems, this procedure may work for you.
The technical term for laser ablation is MRI-guided laser interstitial thermal therapy, but don’t let the wordy name fool you. It’s a fairly simple procedure, especially compared to other surgeries to treat epilepsy.
Neurosurgeon Jorge Gonzalez-Martinez, MD, says laser therapy is less invasive than other approaches. A tiny probe precisely targets the spot in the brain where doctors believe seizures originate.
Using magnetic resonance imaging, a surgeon guides the laser to remove the targeted tissue with controlled heat. In most cases, this reduces or eliminates epilepsy symptoms.
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Laser ablation offers a quick recovery time and few complications.
The procedure requires a 24-hour hospital stay, Dr. Gonzalez-Martinez says. Possible complications include bleeding, infection and stroke, but the risks are low.
“It depends on the area in which we need to do the ablation, but the side effects are minimal — probably a 1 percent or 2 percent risk of complications,” he says.
The relative safety of the approach makes it a good option for patients who have other health problems that make major surgery too risky.
“I believe the huge advantage of laser is for patients who are too sick to have a craniotomy,” says Dr. Gonzalez-Martinez. “If they have cardiovascular problems that will most likely result in increased morbidity with a large procedure like craniotomy, laser may be a good approach.”
Although laser ablation shows promise, the technology is so new that its effectiveness hasn’t yet been fully proven.
Dr. Gonzalez-Martinez says that as doctors treat more patients with laser surgery they learn more about how its results compare with more standard surgery.
He notes that while there’s evidence that laser treatment isn’t quite as effective as craniotomy, the fact that it’s so much less invasive and risky often makes it a good choice anyway. Doctors sometimes repeat the procedure or opt for a craniotomy, if needed, he says.
Dr. Gonzalez-Martinez is optimistic about the role of lasers in the future of treating epilepsy. “This is an evolving technology that is in its infancy at this point, but I think this is the direction the field is going to take,” he says.