MRI Guided Laser Surgery For Epilepsy
Epilepsy is a disorder in which an individual suffers repeated seizures. Epilepsy has a wide variety of causes, but in some patients, lesions on the brain cause the seizures. Until recently, operating on the brain has been extremely dangerous, but advances in technology have allowed for the removal of these lesions through minimally invasive procedures. In 2010, Texas Children’s Hospital became the first hospital in the world to use magnetic resonance imaging (MRI) in real time to guide the insertion of catheters into the brain to remove lesions. Other major hospitals followed suit. The operation works by inserting laser probes into the brain, which are positioned with the help of real-time MRI data. The probes then deliver controlled thermal energy to the lesions to destroy them. The real-time MRI data also reports temperatures inside the brain via the probe.
The NeuroBlate System and Laser Delivery Probes
The NeuroBlate System and Laser Delivery Probes is a medical devices manufactured by Monteris Medical to perform minimally invasive epilepsy surgeries. The NeuroBlate System is designed to remove, thicken or solidify, or destroy cells in the brain tissue. The system relies on real-time MRI scans to guide probes and map out brain lesions, and the FDA has received reports that MRI systems can negatively interact with the Laser Delivery Probes.
In some instances, interaction between MRI systems and the Laser Delivery Probes has caused unexpected heating and damage to the probes. This can heat surrounding brain tissue, causing injury, or allow the carbon dioxide cooling gas inside the probe to leak into the brain. According to the FDA, Medical Device Reports (MDRs), and other literature, adverse events follow, including “neurological deficits (e.g., focal motor deficits, aphasia, cognitive changes), increased intracerebral edema or pressure, intracranial bleeding, and/or visual changes (e.g., visual field deficits, blurry vision), when these devices were used to treat intra-cranial lesions.” The FDA goes on to warn, “Several of these reports note events which required urgent medical and/or surgical intervention, and may have been associated with patient deaths.”