Epilepsy affects 1–2% of the general population, of whom 30–40% may be considered drug resistant. In these patients, surgery is increasingly considered as the treatment of choice. However, conventional epilepsy surgery is invasive and associated with significant risks and overall intervention rates remain low. However, minimally invasive surgery, such as stereotactic radiosurgery and MRI-guided laser interstitial thermal surgery, have become popular alternative treatments, especially when a patient is not fit for a major open surgical procedure.
In this month’s journal club, we will discuss three papers addressing these two modalities used in minimally invasive epilepsy surgery. The first is a clinical trial which randomizes patients with pharmacoresistant temporal lobe epilepsy to either stereotactic radiosurgery or open temporal lobectomy. The second is a systemic review and meta-analysis assessing outcomes of MRI-guided laser interstitial thermal therapy in the treatment of temporal epilepsies, extratemporal epilepsies and hypothalamic hamartoma. The last paper is a retrospective study comparing outcomes of MRI-guided laser interstitial thermal therapy and open temporal lobectomy
