التفاصيل البيبلوغرافية
| العنوان: |
Magnetic resonance imaging-guided stereotactic laser ablation therapy for the treatment of pediatric epilepsy: a retrospective multiinstitutional study. |
| المؤلفون: |
Arocho-Quinones, Elsa V, Lew, Sean M, Handler, Michael H, Tovar-Spinoza, Zulma, Smyth, Matthew D, Bollo, Robert J, Donahue, David, Perry, M Scott, Levy, Michael, Gonda, David, Mangano, Francesco T, Kennedy, Benjamin C, Storm, Phillip B, Price, Angela V, Couture, Daniel E, Oluigbo, Chima, Duhaime, Ann-Christine, Barnett, Gene H, Muh, Carrie R, Sather, Michael D, Fallah, Aria, Wang, Anthony C, Bhatia, Sanjiv, Eastwood, Daniel, Tarima, Sergey, Graber, Sarah, Huckins, Sean, Hafez, Daniel, Rumalla, Kavelin, Bailey, Laurie, Shandley, Sabrina, Roach, Ashton, Alexander, Erin, Jenkins, Wendy, Tsering, Deki, Price, George, Meola, Antonio, Evanoff, Wendi, Thompson, Eric M, Brandmeir, Nicholas, Pediatric Stereotactic Laser Ablation Workgroup |
| المصدر: |
Journal of neurosurgery. Pediatrics, vol 31, iss 6 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2023 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Pediatric Stereotactic Laser Ablation Workgroup, drug-resistant epilepsy, functional neurosurgery, laser interstitial thermal therapy, magnetic resonance imaging–guided stereotactic laser ablation, minimally invasive technique, pediatric epilepsy, seizure focus, Pediatric, Neurosciences, Neurodegenerative, Brain Disorders, Epilepsy, Paediatrics and Reproductive Medicine, Neurology & Neurosurgery |
| جغرافية الموضوع: |
1 - 14 |
| الوصف: |
ObjectiveThe authors of this study evaluated the safety and efficacy of stereotactic laser ablation (SLA) for the treatment of drug-resistant epilepsy (DRE) in children.MethodsSeventeen North American centers were enrolled in the study. Data for pediatric patients with DRE who had been treated with SLA between 2008 and 2018 were retrospectively reviewed.ResultsA total of 225 patients, mean age 12.8 ± 5.8 years, were identified. Target-of-interest (TOI) locations included extratemporal (44.4%), temporal neocortical (8.4%), mesiotemporal (23.1%), hypothalamic (14.2%), and callosal (9.8%). Visualase and NeuroBlate SLA systems were used in 199 and 26 cases, respectively. Procedure goals included ablation (149 cases), disconnection (63), or both (13). The mean follow-up was 27 ± 20.4 months. Improvement in targeted seizure type (TST) was seen in 179 (84.0%) patients. Engel classification was reported for 167 (74.2%) patients; excluding the palliative cases, 74 (49.7%), 35 (23.5%), 10 (6.7%), and 30 (20.1%) patients had Engel class I, II, III, and IV outcomes, respectively. For patients with a follow-up ≥ 12 months, 25 (51.0%), 18 (36.7%), 3 (6.1%), and 3 (6.1%) had Engel class I, II, III, and IV outcomes, respectively. Patients with a history of pre-SLA surgery related to the TOI, a pathology of malformation of cortical development, and 2+ trajectories per TOI were more likely to experience no improvement in seizure frequency and/or to have an unfavorable outcome. A greater number of smaller thermal lesions was associated with greater improvement in TST. Thirty (13.3%) patients experienced 51 short-term complications including malpositioned catheter (3 cases), intracranial hemorrhage (2), transient neurological deficit (19), permanent neurological deficit (3), symptomatic perilesional edema (6), hydrocephalus (1), CSF leakage (1), wound infection (2), unplanned ICU stay (5), and unplanned 30-day readmission (9). The relative incidence of complications was higher in the hypothalamic target location. Target volume, ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt50q4926j; https://escholarship.org/uc/item/50q4926jTest |
| الإتاحة: |
https://escholarship.org/uc/item/50q4926jTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.5DD0C16C |
| قاعدة البيانات: |
BASE |
