Our Summary

This research paper discusses the use of laser interstitial thermotherapy (LiTT) in epilepsy surgeries for both adults and children. Unlike traditional methods, LiTT doesn’t require a large opening in the skull, and can minimize damage to the brain while treating areas that are hard to reach or important for brain function. The paper talks about the history of laser neurosurgery and the features of the two main systems that use LiTT. The researchers also look at the results of around 200 cases where LiTT was used in epilepsy surgery. They found that the success rate of controlling seizures was slightly lower compared with traditional surgery. They also could not definitely prove that LiTT had a lesser impact on cognitive function due to lack of proper research methods. The cost-effectiveness of LiTT also needs more study. The researchers recommend more high-quality, controlled studies to evaluate the use of LiTT in epilepsy surgery.

FAQs

  1. What is laser interstitial thermotherapy (LiTT) and how is it used in epilepsy surgeries?
  2. How does the success rate of controlling seizures with LiTT compare to traditional surgery methods?
  3. Does the use of LiTT in epilepsy surgery have a lesser impact on cognitive function?

Doctor’s Tip

A helpful tip a doctor might tell a patient about brain surgery is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding activities that could put pressure on the surgical site. It’s important to rest and give your brain time to heal properly to ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended for brain surgery include those with:

  • Brain tumors: Surgery may be recommended to remove a tumor or to take a biopsy for diagnosis.
  • Epilepsy: Surgery may be considered for patients who have not responded to medication and have seizures that are localized to a specific area of the brain.
  • Traumatic brain injury: Surgery may be necessary to remove blood clots, repair skull fractures, or reduce pressure on the brain.
  • Vascular malformations: Surgery may be recommended to repair abnormal blood vessels in the brain.
  • Hydrocephalus: Surgery may be necessary to place a shunt to drain excess fluid from the brain.
  • Parkinson’s disease or essential tremor: Deep brain stimulation surgery may be recommended to implant electrodes in the brain to help control movement disorders.
  • Chiari malformation: Surgery may be necessary to relieve pressure on the brain and spinal cord caused by the malformation.
  • Stroke: Surgery may be recommended to remove blood clots or repair damaged blood vessels in the brain.

It is important for patients to discuss their specific condition with their healthcare provider to determine if brain surgery is the best treatment option for them.

Timeline

Before brain surgery:

  1. Patient undergoes various neurological tests and imaging studies to determine the location and severity of the issue requiring surgery.
  2. Patient meets with neurosurgeon and other specialists to discuss the risks and benefits of surgery, as well as other treatment options.
  3. Pre-operative evaluations and preparations are conducted, which may include blood tests, electrocardiogram, and medications adjustments.
  4. Patient is instructed on how to prepare for surgery, including fasting before the procedure.

After brain surgery:

  1. Patient is closely monitored in the recovery room for any immediate complications or side effects.
  2. Patient may experience pain, swelling, and discomfort at the surgical site, which can be managed with medications.
  3. Patient may need to stay in the hospital for a few days to a week, depending on the type of surgery and recovery progress.
  4. Follow-up appointments are scheduled with the neurosurgeon to monitor healing and address any concerns or complications.
  5. Patient may need physical therapy, occupational therapy, or speech therapy to regain lost functions or abilities.
  6. Long-term follow-up care is essential to monitor for any recurrence of symptoms or complications related to the surgery.

What to Ask Your Doctor

  1. What specific type of brain surgery are you recommending for my condition?
  2. What are the potential risks and complications associated with this type of surgery?
  3. What is the success rate of this type of surgery in treating my condition?
  4. How long is the recovery process expected to be, and what can I expect in terms of post-operative care?
  5. Are there any alternative treatment options to consider before proceeding with surgery?
  6. How will this surgery specifically benefit me in terms of improving my symptoms or quality of life?
  7. Will I need any additional tests or evaluations before the surgery can be scheduled?
  8. What is the experience and success rate of the surgical team in performing this type of procedure?
  9. How long have you been performing this type of surgery, and what is your personal success rate with it?
  10. Are there any long-term considerations or lifestyle changes I should be aware of after undergoing this surgery?

Reference

Authors: Hoppe C, Witt JA, Helmstaedter C, Gasser T, Vatter H, Elger CE. Journal: Seizure. 2017 May;48:45-52. doi: 10.1016/j.seizure.2017.04.002. Epub 2017 Apr 6. PMID: 28411414