1 Recommendations

1 Recommendations

1.1 Evidence on the safety of MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy shows there are serious but well-recognised safety concerns. Evidence on its efficacy is limited in quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.

1.2 Clinicians wishing to do MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy should:

1.3 Patient selection should be done by a multidisciplinary team experienced in managing drug-resistant epilepsy. This may include a neurologist, neurosurgeon, neurophysiologist, neuroradiologist and psychiatrist.

1.4 The procedure should only be done in specialist centres by clinicians with experience and specific training.

1.5 Further research could be in the form of randomised controlled trials, large case series or collaborative registries. It should report details of patient selection, including the size and site of the lesions being created, patient-reported outcomes and long-term follow up, particularly neurodevelopmental outcomes in children.

  • National Institute for Health and Care Excellence (NICE)