title: [Stereotactic laser thermocoagulation in epilepsy surgery].
abstract: In common with other stereotactic procedures, stereotactic laser thermocoagulation (SLT) promises gentle destruction of pathological tissue, which might become especially relevant for epilepsy surgery in the future. Compared to standard resection, no large craniotomy is necessary, cortical damage during access to deep-seated lesions can be avoided and interventions close to eloquent brain areas become possible. We describe the history and rationale of laser neurosurgery as well as the two available SLT systems (Visualase® and NeuroBlate®; CE marks pending). Both systems are coupled with magnetic resonance imaging (MRI) and MR thermometry, thereby increasing patient safety. We report the published clinical experiences with SLT in epilepsy surgery (altogether approximately 200 cases) with respect to complications, brain structural alterations, seizure outcome, neuropsychological findings and treatment costs. The rate of seizure-free patients seems to be slightly lower than for resection surgery. Due to the inadequate quality of studies, the neuropsychological superiority of SLT has not yet been unambiguously demonstrated.
authors.affiliation: Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland. christian.hoppe@ukb.uni-bonn.de.
authors.forename: C
authors.initials: C
authors.lastname: Hoppe
authors.affiliation: Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: J-A
authors.initials: JA
authors.lastname: Witt
authors.affiliation: Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Helmstaedter
authors.affiliation: Klinik für Neurochirurgie, Beta Klinik, Bonn, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Gasser
authors.affiliation: Neurochirurgische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Vatter
authors.affiliation: Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: C E
authors.initials: CE
authors.lastname: Elger
mesh_terms: D004827:Epilepsy / Q000000981:diagnostic imaging / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013817:Thermography / Q000379:methods*; D016896:Treatment Outcome
keywords: Magnetic resonance imaging; Patient outcome; Postoperative complications; Thermometry; Treatment costs