SEIZURE DISORDERS: Edited by Philippe RyvlinLaser interstitial thermal therapy in drug-resistant epilepsyShimamoto, Shoichia; Wu, Chengyuanb; Sperling, Michael R.a Author Information aDepartment of Neurology, Jefferson Comprehensive Epilepsy Center bDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA Correspondence to Michael R. Sperling, MD, 901 Walnut St., Suite 400, Philadelphia, PA 19107, USA. Tel: +1 215 955 1222; e-mail: [email protected] Current Opinion in Neurology: April 2019 - Volume 32 - Issue 2 - p 237-245 doi: 10.1097/WCO.0000000000000662 Buy Metrics Abstract Purpose of review MRI-guided stereotactic laser interstitial thermal therapy (LiTT) has been utilized in the surgical treatment of discrete, small epileptogenic lesions. This review summarizes the current literature and addresses the clinical application of this technique. Recent findings LiTT has the potential to reduce the morbidity and discomfort of epilepsy surgery. Review of data from retrospective, uncontrolled studies suggests that LiTT may offer benefit when treating drug-resistant epilepsy because of mesial temporal sclerosis, hypothalamic hamartoma, cavernous hemangioma, and small cortical dysplasias and malformations. It is now being offered as initial therapy in place of anterior temporal lobectomy in many centers, and a prospective study is underway to compare it with historical temporal lobectomy reports. Summary LiTT appears promising and has potential for reduced morbidity and improved tolerability compared with open surgery. Studies must be done to compare efficacy and safety of LiTT with open surgery, and further investigation is needed to optimize this technique. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.