March 12, 2015

Laser technology offers new option to treat epilepsy

Vanderbilt University Medical Center recently debuted a new minimally invasive surgical treatment for epilepsy.

Patient Cory Moquist is recovering well following surgery at Vanderbilt to treat his epilepsy.

Vanderbilt University Medical Center recently debuted a new minimally invasive surgical treatment for epilepsy.

This cutting-edge technique employs MRI-guided laser ablation to destroy the brain tissue causing seizures in place of surgical resection.

For 25-year-old Cory Moquist, the procedure is “opening a lot of doors.” He had the procedure Feb. 16 and is recovering well.

“I’m excited that this could fix my epilepsy for good,” Moquist said. “I take so much medication, and I think I’m more tired than I should be. I feel like I’ve put off starting my career, and this will open everything up.”

A native of Spokane, Washington, Moquist began having seizures at age 2, but was able to control them with medication until a severe seizure at age 18 just before he went to college.

“At the beginning of college I was still pretty much in denial and continued to have seizures every two-three weeks. It’s hard to describe, but it feels like the beginning of a bad dream, and then I’m really out of it afterward. Most people who have seen them say they last 20-30 minutes.”

With the supervision of family and friends, Moquist has always been able to do the outdoor activities he loves. Now he hopes to live an even fuller life seizure-free.

The laser ablation procedure, which uses the Monteris NeuroBlate System, is performed by Joseph Neimat, M.D., associate professor of Neurological Surgery, in consultation with Kevin Haas M.D., Ph.D., neurology director for epilepsy surgery, and in accordance with the consensus recommendation of the full Vanderbilt Epilepsy Surgery Group.

The most common operation for epilepsy is a temporal lobectomy, which removes the brain tissues causing seizures and has a very high rate of success.

“Most people think of surgery for epilepsy as a last resort, but we think it can hugely improve quality of life. This is an improvement on traditional surgery, making it a little less complicated and scary for patients,” Neimat said.

Instead of a big incision and craniotomy, laser ablation uses a stereotactic frame to insert a probe into the abnormal tissue. Under real time MRI guidance, a laser heats the tissue and thermography measures when it has reached the proper temperature.

“The laser therapy allows you to really limit the damage to only the area you want to treat. You can’t do it much less invasively,” Neimat said.

The technology can also be used to treat brain tumors, and Neimat says it may be a good option for tumors very deep in the brain.

“It’s exciting to have these new technologies. If you talk to people nationally who are leading epilepsy programs, they feel the field has changed dramatically in the last five years,” Neimat said.

“It’s estimated that something like 5 percent of the patients eligible for surgery actually get operated on. We’re hopeful these new technologies will make it more feasible to reach and help more epilepsy patients.”