Michael Sperling, MD

“In an utterly noninvasive fashion, you can put people in an ultrasound delivery machine that focuses multiple beams of ultrasound, and where they intersect is where the action takes place, so to speak. You can deliver damage to a very specific, targeted area of brain within a couple of millimeters.”

The field of epilepsy, like many other neurology specialties, has turned some of its focus toward forms of stimulation and neuromodulation for its treatment in the last few years. And now, coming down the pipeline in epilepsy are a number of possible interventions.

One such therapy is focused ultrasound, which allows for physicians to even disrupt the blood-brain barrier to help the delivery of medications. While it is not FDA approved, it has shown promise thus far. Another 2 methods which have regulatory approval are responsive neurostimulation and deep brain stimulation and have begun to make their mark in the field.

 sat with Michael Sperling, MD, director, Jefferson Comprehensive Epilepsy Center, professor of neurology, Thomas Jefferson University, to discuss these methods of noninvasive interventions in epilepsy care.

Sperling M. New therapeutic technologies (focused ultrasound, laser therapy, SEEG, RF ablation and others). Presented at: 2019 International Epilepsy Congress. June 22-26, 2019; Bangkok, Thailand.

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The director of the Jefferson Comprehensive Epilepsy Center discussed what’s currently being developed in the treatment of epilepsy, as well as the emergence of different methods of stimulation and neuromodulation.

Michael Sperling, MD: Noninvasive Techniques in Epilepsy

“Practically, it means that people come into the hospital and go home the next day. For pain relief they use acetaminophen—they don’t need narcotics&mdash;and they can go back to work a couple of days later…It’s at that level, as opposed to 3 days in the hospital with a craniotomy, significant analgesics, people out of work for 4 to 6 weeks. Some of these minimally invasive techniques, while still invasive, are far better than what we have had.”

In the last decade, a number of novel methods—mostly minimally invasive&mdash;of surgical approaches to treating epilepsy have become more widespread. Among them are laser ablation, focused ultrasound, and responsive neurostimulation, among others. Specifically, the use of laser interstitial thermal ablation has grown extraordinarily popular.

 sat with Michael Sperling, MD, director, Jefferson Comprehensive Epilepsy Center, professor of neurology, Thomas Jefferson University, who gave an informative talk at the meeting about a number of new therapeutic technologies in the treatment of epilepsy. Sperling spoke about one specific method, laser ablation, which has been utilized at the Jefferson facility for almost 7 years.

Additionally, he shared insight into how this new minimally invasive method compares to traditional resective surgery in epilepsy, particularly by removing the need for craniotomy and thereby allowing patients to have a much shorter hospital stay and recovery time.

The director of the Jefferson Comprehensive Epilepsy Center spoke about the improvements that have come along with some of the surgical advancements in the treatment of epilepsy, specifically with laser interstitial thermal ablation.

Michael Sperling, MD: Surgical Advancements for Epilepsy

“The biggest gap that we have in epilepsy right now is that we put someone on medicine with no notion of whether it is going to work or not.”

Michael Sperling, MD, has been involved in a number of clinical studies of different interventions and approaches to treating epilepsy, with the ultimate goal of whittling down the list of unmet needs faced by patients with the condition.

Currently, he’s involved as the national principal investigator in a study of the Visualase MRI-guided laser ablation system for the necrotization or coagulation of epileptogenic foci in patients with intractable mesial temporal lobe epilepsy, called the SLATE trial (NCT02844465). He told 

 that he is excited to find out exactly how well this intervention fairs, as it is much less invasive than the current interventions being conducted.

As well, the Baldwin Keyes Professor of Neurology and director of the Jefferson Comprehensive Epilepsy Center at Thomas Jefferson University spoke about the need for biomarkers to indicate the success of treatments in epilepsy, as well as the rising interest in gene therapies for the condition. He sat with 

The Baldwin Keyes Professor of Neurology and director of the Jefferson Comprehensive Epilepsy Center at Thomas Jefferson University spoke about the trial of the Visualase MRI-guided laser ablation system and the unmet needs in epilepsy.

Michael Sperling, MD

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