Abstracts

Rationale: Over the past few years there have been considerable advances in minimally invasive surgical techniques to treat drug resistant epilepsy. Laser interstitial thermal therapy (LITT) is one such minimally invasive procedure which uses real time thermal monitoring to ablate epileptogenic foci. The objective of this study was to evaluate electroencephalogram (EEG) abnormalities, particularly development of Temporal Intermittent Rhythmic Delta Activity (TIRDA) and clinical outcomes such as requirement of further invasive surgery after LITT. Methods: We performed a retrospective chart review of all patients who underwent LITT for drug resistant epilepsy at Mayo Clinic Florida from January 2013 to December 2016. We abstracted baseline demographic characteristics, pertinent clinical variables including pre-operative EEG, post LITT lobectomy and the Engel Surgical Outcome Scale. Results: A total of 37 patients underwent LITT procedure for drug resistant epilepsy within the study period. The majority of patients were male (54%) with a mean age at surgery of 46.4 years (range 17-69.8 years). Of the 37 patients, 13 patients were excluded from the study due to lack of documentation of post-surgical EEG leaving 24 patients for further analysis. A total of 6 patients had anterior temporal lobectomy (ATL) after LITT due to recurrent seizures. Ten patients(41.6%) showed development of TIRDA on EEG after LITT procedure out of which 4 patients (40%) eventually required ATL. Conclusions: The development of TIRDA on EEG post LITT may be a predictive factor for requirement of lobectomy on patients with drug resistant epilepsy. Our primary results show the potential utility of TIRDA in the management of these patients. Future prospective studies are needed to confirm our results. Funding: No funding was received in support of this abstract.