Dr. Peter Warnke, associate professor of surgery and director of stereotactic and functional neurosurgery at the University of Chicago Medicine, has been working with a new stereotactic technique to treat focal epilepsy that uses a laser fiber to ablate, or basically burn away, the troublesome nerve cells in the lesion causing the seizures. Using 3D images of the brain as a guide, they insert a laser fiber, less than 2 mm thick, through a small incision and place it next to the lesion. Then they take the patient to an MRI machine and send a laser beam through the fiber to heat up the tissue.
As this happens, Warnke and his team can measure the temperature of the beam via the MR images. The longer the heat is applied, the further it spreads through the surrounding tissue, and once the necessary heat has fully covered the lesion, they stop and pull out the fiber through the skin.
“You can plan these procedures exactly, and you avoid the side effects of going through eloquent brain and causing potential damage,” Warnke said. “The infection risk is much, much lower than open surgery, the cognitive and psychological side effects of operating in these deep areas of the brain are much less.”
Warnke said that after traditional surgery to remove focal lesions, about 68 percent of patients are seizure-free. But in early trials of the laser fiber procedure at other institutions almost 99 percent of patients are seizure-free after 6 months. He’s not ready to use the word “cure” until patients have gone more than 3 years without seizures, but he’s encouraged by the effectiveness and precision of these early results.
“The real advantage of the laser ablation is that you can watch the procedure online while you do it without opening the brain and seeing what you do. That’s the beauty of the concept,” he said.
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