Laser Ablation (LITT) for Epilepsy
Laser interstitial thermal therapy (LITT) is a minimally invasive epilepsy surgery option that uses focused heat to treat selected seizure-causing brain tissue.
Epilepsy surgery pathway
From evaluation to long-term seizure care
Evaluation
Review history, imaging, EEG results, and medication response.
SEEG and mapping
Use video-EEG, imaging, and sEEG when needed to localize where seizures begin, how they spread, and what functions are nearby.
Decision
Choose resection, ablation, neuromodulation, further mapping, or non-surgical care.
Treatment
Carry out the selected procedure with a plan for safety, recovery, and seizure goals.
Follow-up
Track seizure control, medications, recovery, mood, and device settings when needed.
Precision mapping
MRI, video-EEG, neuropsychology, and sEEG when deeper localization is needed.
Tailored treatment
Resection, laser ablation, or neuromodulation selected around seizure anatomy and goals.
Long-term planning
Device programming, follow-up, and medication strategy coordinated with the epilepsy team.
Overview
Laser interstitial thermal therapy (LITT), often called laser ablation, is a minimally invasive epilepsy surgery option for selected patients with drug-resistant focal seizures. It uses a precisely placed laser fiber to heat and treat seizure-causing tissue while limiting disruption to surrounding areas.
Who it is for
LITT may be appropriate when testing identifies a focused seizure source that can be safely targeted through a minimally invasive path. It is often considered for selected deep or well-defined seizure targets, depending on the patient’s anatomy and full epilepsy evaluation.
How the procedure works
Using image guidance, a laser fiber is placed through a small opening in the skull and advanced to the planned target. The tissue is then heated under real-time imaging guidance. Patients typically have a shorter incision and recovery than with many open epilepsy operations, although the right approach depends on the seizure focus.
LITT is still epilepsy surgery, and it requires the same discipline in patient selection. The target must be clearly defined, the safest trajectory must be planned, and nearby critical structures must be considered before treatment.
How LITT compares with other options
Laser ablation can be attractive when the seizure focus is deep or compact, or when a less invasive approach may reduce recovery burden. Open resection may still be the better option when a larger region needs treatment, when tissue diagnosis is important, or when the seizure network cannot be adequately treated through a laser trajectory. Neuromodulation may be more appropriate when the seizure focus cannot be safely ablated or removed.
Dr. Barone’s approach
Dr. Barone evaluates LITT alongside the full range of epilepsy surgery options, including resective surgery, sEEG-guided planning, RNS, VNS, and DBS, to match the treatment to the safest and most effective path for each patient.
Frequently asked questions
What is LITT for epilepsy? +
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure that uses a laser fiber placed through a small opening to heat and treat selected seizure-causing tissue.
Who may be a candidate for laser ablation? +
LITT may be considered for selected patients with drug-resistant focal epilepsy when the seizure focus is well defined and can be treated safely with a minimally invasive approach.
How is LITT different from open epilepsy surgery? +
LITT uses a small opening and image-guided laser treatment instead of a larger craniotomy. It is not right for every seizure focus, but it can be a useful option for carefully selected targets.
Considering treatment for Laser interstitial thermal therapy for epilepsy?
Dr. Barone evaluates new patients and referrals at Houston Methodist Hospital, Houston. Patients from outside Houston, across the United States, and internationally are welcome.