UI Health Care first in state to use minimally invasive laser surgery for patients with epilepsy

Brian Dlouhy performs a procedure on a pediatric epilepsy patient

“I see this procedure becoming the new gold standard of care.” 

Nearly one in three people who have epilepsy could benefit from surgery, yet they are often held back by a fear of the risks of an open craniotomy. It may take years of debilitating seizures and multiple failed medication attempts before they are referred to a surgeon. 

Minimally invasive procedure for quicker recovery

Brian Dlouhy, MD, a neurosurgeon with University of Iowa Health Care, is hoping to change this by giving Iowans access to a new, minimally invasive surgical technology called laser interstitial thermal therapy (LITT). 

More than 10 people—both children and adults—have undergone a LITT procedure since UI Health Care became the first in the state to procure the system in late 2021. During the procedure, neurosurgeons insert an MRI-guided laser probe into a small, pencil-sized hole in the patient’s skull. The laser is used to heat and destroy affected tissue with high precision, minimizing harm to the nearby healthy brain tissue.  

“With a traditional craniotomy, you might have to remove one area of the brain to reach the part of the brain you need to target, which increases the risk to the patient,” Dlouhy says. “LITT only requires a small surgical incision to insert the laser probe and allows us to reach the area of the brain we are targeting with more precision.” 

Not only does this reduce the risk for patients and allow for speedier recovery, says Dlouhy, but it also helps many patients feel more comfortable with early surgical intervention. Patients typically go home within one day of the procedure.  

“I see this procedure becoming the gold standard of care,” he says. 

Untreated epilepsy has devastating consequences

Epilepsy can begin at any age, but it is most often diagnosed in young children. If left untreated, the consequences can be devastating. Adult patients who have lived with uncontrolled seizures for many years frequently have significant cognitive issues and intellectual disabilities.  

Having active seizures also increases the risk of injury or death, and sadly, each year there are people who die from sudden unexpected death in epilepsy (SUDEP). UI Health Care has a SUDEP research program seeking to understand the underlying causes of this tragic outcome in order to prevent it. 

Still, despite the dangers people with epilepsy face, many opt to spend years trying to control seizures with medication before finally considering surgery. Multiple published studies show that patients who fail to achieve seizure freedom after two medications have a less than five percent chance of achieving seizure freedom when prescribed additional drug regimens. 

Better outcomes with early intervention

“We see much better outcomes when we are able to treat epilepsy at an earlier age, but many parents are understandably hesitant about surgery,” Dlouhy says. “Now that we have a minimally invasive option available through LITT, I’m hopeful we will be able to help a lot more people become ‘seizure-free’ sooner.” 

The UI Department of Neurosurgery has also performed the LITT procedure on patients afflicted by brain tumors in lieu of traditional open surgery. Brain tumor patients experience the same benefits from the LITT procedure as patients with epilepsy: a short hospital stay, a low rate of complications, and quick recovery.