Abstracts

Rationale: Temporal lobe surgery for the management of medically-resistant mesial temporal lobe epilepsy (MTLE) is considered a safe and effective treatment. However, co-morbidities and surgical complications are a concern in the older population (50 and above). Recently, less invasive techniques such as laser ablation therapy have been studied as a potential option for the treatment of MTLE. To our knowledge, no studies have been performed to evaluate the safety and efficacy of laser ablation therapy in this population. Methods: Five consecutive patients (50 and above) that underwent laser ablation therapy (LAT) for MTLE were followed prospectively to assess length of stay (LOS), complications, neuropsychology results and outcomes. These results were compared (retrospectively) with 5 consecutive patients (50 and above) who underwent selective anterior-mesial temporal lobe (AMTL) resections for the management of MTLE. Results: Demographics were comparable in both groups (mean age: 56 (LAT) vs. 54 (AMTL)), There were no major complications in either group at last follow-up. One patient that underwent laser ablation therapy had an early post-operative seizure, but otherwise both groups are seizure control at last follow-up (mean follow-up: LAT: 3months vs AMTL: 6 months). Mean LOS was 1.5 days for LAT group vs 3.4 days for AMTL group. Early neuropsychology evaluation demonstrated similar results in both populations. Conclusions: Short-term follow-up suggests that LAT is safe and effective therapy. Comparable outcomes to AMTL resection for the management of MTLE were obtained in this population. The main advantage seems to be a shorter LOS in patients that undergo less invasive surgical techniques. Further studies are necessary to assess long-term benefits of laser ablation therapy for the management of medically-resistant epilepsy.