Treatment extends hope to patients with medication-resistant epilepsy
Findings of a study on a novel and minimally invasive laser therapy for patients with drug-resistant epilepsy caused by periventricular nodular heterotopia (PNVH) have been published by UTHealth Houston researchers in the American Neurological Association’s Annals of Neurology.
Led by Nitin Tandon, MD, professor in the Vivian L. Smith Department of Neurosurgery at McGovern Medical School and vice president for Strategy and Development at UTHealth Houston Neurosciences, the research is a promising option for patients with PNVH, who often suffer from hard-to-control seizures. Tandon also holds the BCMS Distinguished Professorship in Neurological Disorders and Neurosurgery and the Nancy, Clive and Pierce Runnells Distinguished Chair in Neuroscience of the Vivian L. Smith Center for Neurologic Research.
The study, performed by the Texas Comprehensive Epilepsy Program team at McGovern Medical School, examined the effectiveness of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT), guided by detailed brain mapping using stereo-electroencephalography (SEEG). The procedure uses a laser to precisely target and destroy abnormal brain tissues responsible for causing the seizures.
The study reviewed 39 patients who underwent the SEEG-guided MRgLITT procedure. These patients had all experienced medication-resistant epilepsy linked to PVNH. By using the laser to remove the brain regions responsible for triggering seizures, the treatment showed promising results, with up to 80% of patients with localized abnormal brain tissue becoming seizure-free.
“Our team’s findings suggest that MRgLITT could be a safe, feasible, and highly effective life-changing option for patients whose seizures have been unmanageable with medication,” Tandon said. “We found that the procedure is extremely precise and prevents the need for more invasive brain surgeries.”
Treating PVNH has been challenging because the condition involves clusters of brain cells that don’t move to the correct location within the brain during prenatal development, said co-author Samden Lhatoo, MD, professor and executive vice chair in the Department of Neurology and the John P. and Kathrine G. McGovern Distinguished Chair at McGovern Medical School. Lhatoo is also a director of the Texas Comprehensive Epilepsy Program along with Tandon.
“The neurons are located near the brain’s ventricles instead of being part of the brain’s outer layer, where they belong. These misplaced cells are located deep in the brain near the ventricles, making them harder to reach and treat with traditional therapies. The ability to pinpoint and target the exact regions of the brain responsible for the drug-resistant epilepsy is a potential game-changer. Our breakthrough study offers a new option for individuals who have long struggled with seizures that impact their daily lives,” he said.
UTHealth Houston co-authors include Ryan McCormack, MD, PhD; Arjun S. Chandran, MD; Sandipan Pati, MD; Katherine Harris, MD; Nuria Lacuey Lecumberri, MD, PhD; and Stephen Thompson, MD.