Published October 24, 2013
Over 3 million people suffer from epilepsy in the United States, and past treatment options have been limited to medication or open brain surgery.
Now, a technique called laser ablation is giving neurosurgeons a less-invasive way to eliminate seizures.
Dr. Shabbar Danish, director of functional neurosurgery at Robert Wood Johnson Hospital and assistant professor of surgery at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J., is part of one of the few teams in the country that perform this cutting-edge procedure.
"If you could achieve the same exact outcome without opening up your head, why would you?” said Danish. “…In all of medicine we're looking for minimally invasive procedures."
Neurosurgeons insert a fiber-optic cable into a small hole in the skull that is just 3 millimeters in diameter. Then, using guided imagery, they thread it past blood vessels and healthy gray matter into the targeted brain lesion without damaging any healthy brain tissue. The laser uses thermal energy to wipe-out problematic tissue, while the surgical team monitors temperature in real time through magnetic resonance imaging (MRI).
"By using a non-ionizing radiation source, we are able to deliver heat, kill what you want to destroy, and save what you don't want to," Danish said.
The procedure has significantly helped 33-year-old Melissa Thomas, of Plainfield, N.J., who had been living with epilepsy for 12 years.
"Living with medication at such a young age was very difficult. Maintaining a schedule, remembering to take my medicine, and then later in life being a mom – life hasn't been normal," Thomas said.
When Thomas’ medications stopped working and her seizures spun out of control, her family urged her to look into surgery. After meeting with Danish, she decided she had nothing to lose and went for it.
"I didn't want my daughter to see me living like that,” Thomas said. “And I knew I had a chance for her to see mommy not taking medicine, asking ‘Mommy are you having a seizure?’ So why not?"
Thomas was released the day after surgery, and she hasn't had a seizure in six months.
"It's just my normal life all over again," she said.
Danish said the procedure has a wide range of candidates, including those with inoperable brain tumors, and those who have been maximally radiated.
"Anytime a patient is told, ‘There is nothing that can be done,’ they should think about this," Danish said.