Abstract：
OBJECTIVE: Magnetic resonance imaging-guided laser interstitial thermal therapy (MRIgLITT) has been proven safe and effective for the treatment of focal epilepsy of different etiologies. It has also been used to disconnect brain tissue in more extensive or diffuse epilepsy, such as corpus callosotomy and hemispherotomy.
METHODS: In this study, we report a case of temporo-parieto-occipital disconnection surgery performed using MRIgLITT assisted by a robotic arm for refractory epilepsy of the posterior quadrant. A highly realistic cadaver simulation was performed before the actual surgery.
RESULTS: The patient was a 14-year-old boy whose seizures began at the age of 8. The epilepsy was a result of a left perinatal ischemic event that caused a porencephalic cyst, and despite receiving multiple antiepileptic drugs, the patient continued to experience daily seizures which led to the recommendation of surgery.
CONCLUSIONS: A Wada test lateralized language in the right hemisphere. Motor and sensory function was confirmed in the left hemisphere through magnetic resonance imaging functional studies and NexStim. The left MRIgLITT temporo-parieto-occipital disconnection disconnection was achieved using 5 laser fibers. The patient followed an excellent postoperative course and was seizure-free, with no additional neurological deficits 24 months after the surgery.
METHODS: In this study, we report a case of temporo-parieto-occipital disconnection surgery performed using MRIgLITT assisted by a robotic arm for refractory epilepsy of the posterior quadrant. A highly realistic cadaver simulation was performed before the actual surgery.
RESULTS: The patient was a 14-year-old boy whose seizures began at the age of 8. The epilepsy was a result of a left perinatal ischemic event that caused a porencephalic cyst, and despite receiving multiple antiepileptic drugs, the patient continued to experience daily seizures which led to the recommendation of surgery.
CONCLUSIONS: A Wada test lateralized language in the right hemisphere. Motor and sensory function was confirmed in the left hemisphere through magnetic resonance imaging functional studies and NexStim. The left MRIgLITT temporo-parieto-occipital disconnection disconnection was achieved using 5 laser fibers. The patient followed an excellent postoperative course and was seizure-free, with no additional neurological deficits 24 months after the surgery.
摘要：
磁共振成像引导的激光间质热疗法（MRIgLITT）已被证明可安全有效地治疗不同病因的局灶性癫痫。它也被用于在更广泛或弥漫性癫痫中断开脑组织，如骨体切开术和半球切开术。在这项研究中,我们报告了1例使用MRIgLITT在机械臂辅助下进行的颞-枕-枕分离术(TPO)治疗后象限难治性癫痫的病例.在实际手术之前进行了高度逼真的尸体模拟。该患者是一个14岁的男孩，其癫痫发作始于8岁。癫痫是由于左围产期缺血事件引起的脑后囊肿，尽管接受了多种抗癫痫药物，患者持续每天癫痫发作，因此建议进行手术。Wada测试右半球的横向语言。通过MRI功能研究和NexStim®证实了左半球的运动和感觉功能。使用五根激光纤维实现左MRIgLITTTPO断开。患者术后病程良好，无癫痫发作，手术后24个月没有额外的神经功能缺损。
