INTRODUCTION

Epilepsy is one of the most common chronic neurological disorders and affects 1% of the world’s population, approximately 60 million worldwide.  Despite significant advances in pharmacological treatment over the last several decades, 30-40% of patients will become resistant to the treatment of anti-epileptic drugs. Epilepsy surgery remains the most effective treatment for drug resistant epilepsy. However, traditional epilepsy surgery requires a large opening of the skull (craniotomy) to resect abnormal brain tissue, which is often associated with increased risks of cognitive impairment and focal neurological deficits.  As a result, many epilepsy patients are often reluctant to seek such effective treatment.

Several minimally invasive surgical techniques such as radiosurgery, radiofrequency thermal ablation and MR-guided laser interstitial thermal therapy (LITT) have been developed over the last decade as potential alternatives to the traditional epilepsy surgery.  Among these techniques, MR-guided laser interstitial thermal therapy (LITT) has merged as a promising and potentially paradigm-shifting new technique, which can create brain lesions with little damage to surrounding tissues.  Early data suggest that LITT is associated with favorable surgical outcomes and superior preservation of cognitive function in patients with mesial temporal lobe epilepsy (mTLE). LITT is also an attractive treatment for epilepsy patients with hypothalamic hamartoma (HH), cerebral cavernous malformations (CCMs), focal cortical dysplasia and Lennox-Gastut syndrome (LGS, Collasotomy).  Recently published data, the institutional experience at the University of Chicago and detailed case discussions related to minimally invasive epilepsy surgery will be presented in the symposium.

This symposium was sponsored by the University of Chicago Beijing center. The goal of this symposium was to promote clinical and scientific collaborations and exchanges between physicians and scholars at the University of Chicago and institutions in China by leveraging our combined patient resources, educational strengths and trainee interests.

Professor Peter Warnke, an eminent functional neurosurgeon, was the featured speaker at the symposium. He is the Director of Stereotactic and Functional Neurosurgery at the University of Chicago, and the Associated Editor of Journal of Neurology, Neurosurgery and Psychiatry.

微创癫痫手术论坛

会议简介

癫痫是最常见的神经系统疾病之一，全球患病率为1%，患病总人数约有6000万。虽然过去几十年中癫痫的药物治疗取得了很大进步，但仍有30-40%的患者成为耐药性癫痫。对于这些患者，切除性的癫痫手术是最为有效的治疗方法。然而，传统的癫痫外科手术需要通过开颅手术（通常需要大片的切开颅骨）以切除异常的脑组织，这常导致认知功能损害及局灶性神经功能缺陷。因此，很多患者并不愿意接受这种有效的治疗方案。

过去的十余年里，微创癫痫手术技术得到发展，如放射外科、高频射频消融术和磁共振引导下激光热疗术（laser interstitial thermal therapy，LITT），它们可能能部分代替传统的癫痫外科手术。其中磁共振引导下的LITT技术的优势非常明显，它能比较特异性的损毁致痫灶，而且对周边组织损伤比较小，因而极具前景。新近的研究数据证实，LITT治疗颞叶内侧面癫痫（mTLE）的优势更为明显，不仅手术疗效好，还很好保存了认知和记忆相关的重要脑区。LITT技术还能很好用于下丘脑错构瘤，海绵样血管瘤，Lennox-Gastut综合征的治疗。在本会议中，讲者将总结新近的研究进展，介绍手术操作，分享芝加哥大学癫痫中心的经验，并做病例展示。

论坛由芝加哥大学北京中心和北京市抗癫痫协会赞助，目的在于借助于我们共同的患者资源、教育力量及学生资源，促进中国的临床医师、研究者与芝加哥大学相关专家的合作与交流。会议特邀讲者是Peter Warnke教授，他是著名的功能神经外科医生，芝加哥大学立体定向及功能神经外科主任，也是（JNNP）杂志的副主编。

AGENDA
8:00-8:45 Registration
9:00-9:15  Welcome and Opening Remarks
   James Tao, The University of Chicago
   ZHANG Guojun, Xuanwu Hospital, Capital Medical University

   Judith Farquhar, The University of Chicago Center in Beijing

Morning Session Chairs: WU Xun & ZHANG Guojun
9:15-9:55  Challenges in the Management of Drug Resistant Epilepsy
Sandra Rose, The University of Chicago
9:55-10:35 Traditional Epilepsy Surgery for Drug Resistant Epilepsy: An Overview
James Tao, The University of Chicago
10:35-11:00  Q&A (10 minutes) & Break (15 minutes)
11:00-11:40 Minimal Invasive Techniques for Epilepsy Surgery: Radiosurgery, Radiofrequency Thermal Ablation and MR-guided Laser Interstitial Thermal Therapy (LITT)
Peter Warnke, The University of Chicago
11:40-13:10 Q&A (15 minutes) & Lunch

Afternoon Session Chairs: ZHU Junming (2nd Affiliated Hospital, School of Medicine, Zhejiang University)
& WANG Xiaofei (Beijing Children’s Hospital, Capital Medical University)
13:10-13:50 Surgical Outcomes of 2000 Patients with Drug Resistant Epilepsy in a Single Center 
YU Tao, Xuanwu Hospital, Capital Medical University
13:50-14:30 Epilepsy Pre-surgical Evaluation and the Utility of Stereo-encephalography (SEEG) for Minimally Invasive Epilepsy Surgery 
Shasha Wu, The University of Chicago
14:30-14:55  Q&A (10 minutes) & Break (15 minutes)
14:55-15:35  MR-guided Laser Interstitial Thermal Therapy (MRgLITT) for Medically Refractory Epilepsy: Indications, Efficacy and Complications
Peter Warnke, The University of Chicago
15:35-16:15 Cognitive Outcomes of MR-guided Laser Interstitial Thermal Therapy (MRgLITT) in patients with temporal lobe epilepsy
Shasha Wu, The University of Chicago
16:15-16:40  Discussion and Conclusion

会议议程
8:00-8:45 会议报到
8:45-9: 15 欢迎致辞
陶经祥，芝加哥大学
张国君，首都医科大学宣武医院

冯珠娣，芝加哥大学北京中心

上半场 主持：吴逊  张国君
9:15-9:55 药物难治性癫痫治疗中的挑战
Sandra Rose，芝加哥大学
9:55-10:35 药物难治性癫痫的传统手术治疗（概述）
陶经祥，芝加哥大学
10:35-11:00 提问（10分钟）+茶歇（15分钟）
11:00 -11:40 微创癫痫手术技术：放射外科、高频射频消融术及磁共振引导下激光热疗术 
Peter Warnke，芝加哥大学
11:40-13:10 讨论（15分钟）+ 午餐
下半场 主持： 朱君明（浙江大学医学院附属第二医院）&
王晓飞（首都医科大学附属北京儿童医院）
13:10-13:50 难治性癫痫的手术治疗：单中心15年来2000例患者的回顾
遇涛，首都医科大学宣武医院
13:50-14:30 癫痫的术前评估及立体定向脑电图在微创癫痫外科中的应用
武莎莎，芝加哥大学
14:30-14:55 讨论（10分钟）+茶歇（15分钟）
14:55-15:35 磁共振引导下激光热疗术（MRgLITT）在难治性癫痫治疗中的应用：适应症、有效性及禁忌症
Peter Warnke, 芝加哥大学
15:35-16:15 磁共振引导下激光热疗术（MRgLITT）对颞叶癫痫患者认知的影响  
武莎莎，芝加哥大学
16:15-16:40 讨论和总结