• Santiago Candela-Cantó, José Hinojosa, Jordi Muchart, Cristina Jou, Laura Palau, Carlos Valera, Cecilia Flores, Andrea Palacio-Navarro, María Alejandra Climent, Anna Pascual, Adrià González, Diego Culebras, Mariana Alamar, Victoria Becerra, Javier Aparicio, and Jordi Rumià.
• Neurosurgery Department, Sant Joan de Déu Barcelona Children's Hospital, Universitat de Barcelona, Barcelona, Spain; Epilepsy Surgery Unit, Sant Joan de Déu Barcelona Children's Hospital, Universitat de Barcelona, Barcelona, Spain. Electronic address: santiago.candela@sjd.es.
• World Neurosurg. 2024 Jul 1; 187: 124132124-132.

ObjectiveMagnetic resonance imaging-guided laser interstitial thermal therapy (MRIgLITT) has been proven safe and effective for the treatment of focal epilepsy of different etiologies. It has also been used to disconnect brain tissue in more extensive or diffuse epilepsy, such as corpus callosotomy and hemispherotomy.MethodsIn this study, we report a case of temporo-parieto-occipital disconnection surgery performed using MRIgLITT assisted by a robotic arm for refractory epilepsy of the posterior quadrant. A highly realistic cadaver simulation was performed before the actual surgery.ResultsThe patient was a 14-year-old boy whose seizures began at the age of 8. The epilepsy was a result of a left perinatal ischemic event that caused a porencephalic cyst, and despite receiving multiple antiepileptic drugs, the patient continued to experience daily seizures which led to the recommendation of surgery.ConclusionsA Wada test lateralized language in the right hemisphere. Motor and sensory function was confirmed in the left hemisphere through magnetic resonance imaging functional studies and NexStim. The left MRIgLITT temporo-parieto-occipital disconnection disconnection was achieved using 5 laser fibers. The patient followed an excellent postoperative course and was seizure-free, with no additional neurological deficits 24 months after the surgery.Copyright © 2024 Elsevier Inc. All rights reserved.

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