NeuroBlate Laser Therapy Shows Promise in Large Study of Drug-Resistant Mesial Temporal Lobe Epilepsy

Patrick Landazuri, MD

Patrick Landazuri, MD

(Credit: University of Kansas Medical Center)

Monteris Medical recently published data from a large cohort of patients with drug-resistant mesial temporal lobe epilepsy (NCT02392078), showing that laser interstitial thermal therapy (LITT) using the NeuroBlate System was well tolerated and displayed clinically meaningful seizure outcomes as well as quality of life improvements. Published in JAMA Neurology, these results suggest that LITT could be considered a safe minimally invasive surgical treatment option for drug-resistant MTLE.^1,2

Among 145 patients (women, n = 73) with MTLE who underwent LITT, 77 of them reached 2-year follow-up. Among them, findings revealed that 45 (58.4%) patients and 44 (57.2%) patients achieved Engel 1 and International League Against Epilepsy 1/2 status, respectively, after 2 years of treatment. The median hospital stay was 1 (IQR, 1-3) day, with 33 patients requiring no ICU stay (23%) and a median ICU time of 22 (IQR, 19.2-28.8) hours. Most patients (n = 140) were discharged home, with a mean post procedure head pain score of 2.1 (SD, 2.6) on a 0-10 scale.

"This study provides the strongest prospective data to date supporting the durability and effectiveness of LITT for drug-resistant mesial temporal lobe epilepsy with multicenter data showing 58% of patients free of disabling seizures at two years follow up, similar to the seminal trial for anterior temporal lobectomy (ATL)," lead author Patrick Landazuri, MD, a professor of neurology at the University of Kansas Medical Center, said in a statement.¹ "As most patients were discharged a day following the procedure with a low head pain score, these data indicate LITT as a well-tolerated, lasting treatment. With reasonably similar outcomes to ATL, as a minimally invasive technique, LITT can be particularly beneficial for patients who prefer to avoid the risks and recovery associated with open brain procedures."

The study, named Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN), is a prospective multicenter registry with up to 5 years of follow-up between October 2015 and March 2023 at level 4 epilepsy sites (n = 50) in the United States. LAANTERN included both adult and pediatric participants who underwent LITT for drug-resistant MTLE with at least 6 months of follow-up, while excluding those with epilepsy related to a malignant lesion. The mean age for participants was 39.2 (SD, 15.4) years at time of LITT, with 14 patients who were younger than 22 years. 

READ MORE: LivaNova’s VNS Therapy Maintains Effectiveness in Drug-Resistant Epilepsy in Latest 2-Year Data

In the study, researchers reported that the most common underlying causes were mesial temporal sclerosis (n = 74) and unknown or normal MRI findings (n = 31). The average ablation volume was 28.2 (SD, 29.8) mL, with a mean surgery time of 4.3 (SD, 2.1) hours and average blood loss of 22 (SD, 17.6) mL. Adverse events occurred in 24 patients (16.5%), mostly reported as mild and temporary. In addition, investigators observed that pediatric outcomes were comparable to adults, and about 1/3 of patients reduced or stopped antiseizure medications. Moreover, researchers noted that quality of life improvements were observed at nearly all follow-up points.

"Our sole purpose at Monteris Medical is to create cutting-edge, minimally invasive technology that can forever change patients' lives for the better. To that end, we continue to build upon our well-established and recognized leadership position in prospective evidence generation for LITT," Martin J. Emerson, president and chief executive officer at Monteris Medical, said in a statement.¹ "We are especially proud that this eighth publication from our LAANTERN study convincingly supports the use of NeuroBlate for those with the most common form of drug-resistant epilepsy. We congratulate the investigators and their patients for their work to show that laser ablation sits alongside craniotomy in terms of seizure freedom but with the superior recovery benefits and lower complications that our minimally invasive technology offers."

The company noted that recovery experiences differ between traditional open surgery and the NeuroBlate procedure. Traditional surgery typically requires removal and replacement of a portion of the skull, often resulting in longer hospital stays, including time in the intensive care unit, and a more extended recovery period. The NeuroBlate procedure, by comparison, uses a small skull opening approximately the size of a pencil, with patients frequently discharged the following day and requiring minimal sutures.

REFERENCES
1. Monteris Medical Announces Largest Prospective Publication to Date in JAMA Neurology on LITT for Epilepsy Cohort Using the NeuroBlate® System. News Release. Monteris Medical. Published July 15, 2025. Accessed July 15, 2025. https://www.prnewswire.com/news-releases/monteris-medical-announces-largest-prospective-publication-to-date-in-jama-neurology-on-litt-for-epilepsy-cohort-using-the-neuroblate-system-302505515.html
2. Landazuri P, Cheng JJ, Leuthardt E, Kim AH, Southwell DG, Fecci PE, Neimat J, Sun D, Lega B, Panov F, Chiang V, Abel T, Ben-Haim S, Piccioni DE, Shih JJ, Palys V, Rodriguez A, Bandt SK, Petronio J, Lacroix M, Baumgartner J. Interstitial Thermal Therapy in Mesial Temporal Lobe Epilepsy. JAMA Neurol. 2025 Jul 7:e251897. doi: 10.1001/jamaneurol.2025.1897. Epub ahead of print. PMID: 40622685; PMCID: PMC12235534.