Hoag’s Pickup Family Neurosciences Institute Selected to Participate in Study of Pioneering Surgical Epilepsy Treatment

Orange County residents who are suffering medication-resistant epilepsy can now access a pioneering, minimally invasive surgical procedure to relieve seizures. Pickup Family Neurosciences Institute (PFNI) at Hoag is one of only three sites in the western U.S. to offer the procedure, MRI-guided laser ablation, through a clinical trial.

For nearly 50 years, there were few options for patients who suffer from medication-resistant temporal lobe epilepsy. The most effective procedure was temporal lobectomy, a highly invasive surgery that involves removing a large section of the brain and can result in loss of vision, speech, memory and neurocognitive abilities.

The SLATE clinical trial will study the effectiveness of minimally invasive laser surgery using the Medtronic Visualase system. This approach uses an MRI-guided laser probe, approximately the width of a guitar string, to target and destroy the scar, tumor, or malformation that causes seizures. The procedure is revolutionizing the surgical treatment of epilepsy, previously a large and invasive surgery with numerous potential side effects, which may now be performed in a minimally invasive procedure requiring an overnight hospital stay.

“We are privileged to be on the forefront of offering minimally invasive, safer options for patients who wish to avoid large, open surgery,” said Chief of Epilepsy Surgery and Hoag neurosurgeon Vik Mehta, M.D., who is the principal investigator of the trial. “In order to meet the needs of people with epilepsy, we need to modernize approaches that are more patient-friendly. This is one of the promising options to replace an invasive approach that had a lot of side effects, and we are excited by the data so far.”

Hoag is the only site in the national study to employ Surgical Theater, which combines the use of virtual reality and augmented reality to “rehearse” surgery. This ensures the safest and most effective approach during the procedure.

Of the 14 patients that Hoag has treated with the Medtronic Visualase MRI-guided laser ablation system, 11 are completely seizure-free. One of these patients, Lisa Egli, suffered from temporal lobe seizures since childhood, but is now seizure-free for more than a year since undergoing laser ablation surgery with Dr. Mehta. She has been steadily reducing the amount of anti-seizure medication she takes under the direction of David Millett, M.D., Ph.D., Epilepsy Program Director at Hoag

“At work, I stand up in front of people and present, and I was always paranoid about having seizures. I am not anymore,” she said. “I feel like my memory has improved, as well. I’ve been surprised how much better the quality of my life is.” Indeed, early data also suggest that laser ablation also drastically reduces the risk of side effects.

Nearly one million people who have epilepsy either don’t respond to anti-seizure medication or find medication gradually becomes ineffective at controlling their seizures. For these patients, temporal lobectomy has proven effective, but it is so invasive that only a small fraction of patients elects to undergo the surgery. Hoag’s multidisciplinary epilepsy program at the PFNI is using this new minimally invasive approach to open a new avenue of effective treatment to patients who have had limited options.

“Over time, people with medication-resistant epilepsy become progressively more disabled. They’re not able to keep their jobs, or drive or maintain relationships,” said Dr. Millett. “If we can cure them of their seizures, we can give them their life back.”

The PFNI at Hoag has consistently ranked among the top one percent of hospitals in the nation for neurology and neurosurgery. The hospital has been designated a Center of Excellence in Robotic Surgery (COERS) from the Surgical Review Corporation. And Hoag is accredited by the National Association of Epilepsy Centers as a level 4 epilepsy center, meaning it has the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy.

The hospital’s track record of excellence is one reason Hoag was chosen to participate in the study.

“Patients need a well-trained epileptologist to tease out what types of seizures they are having and what treatments they need,” said Dr. Millett. “For some patients, surgery is the best option. Hoag was chosen to participate in this study because our expertise in identifying and treating epilepsy is among the most trusted in the nation.”

Drs. Millett and Mehta said they hope the study will result in a sea change for patients whose epilepsy cannot be controlled by medication.

“The goal is to achieve high rates of seizure-freedom with minimal side effects, a very low risk profile and short hospital stay,” Dr. Mehta said. “We are excited to be a part of this study and to pioneer an effective option for patients with seizure disorders.”

For more information about the clinical trial, please contact [email protected].  

Compassionate Care, Clinical Excellence, Creative Intelligence
Hoag and the Pickup Family Neurosciences Institute were ranked by U.S. News & World Report as the No. 1 hospital in Orange County and No. 27 nationally in Neurology & Neurosurgery, placing it in the top 1% of neuro-specialist programs across the U.S., and the only one in the top 30 without a formal university residency curriculum. Delivering a personalized, integrated approach using best-practice guidelines, the most advanced technology, and integration of medical specialists in the most appropriate facilities, the Pickup Family Neurosciences Institute (PFNI) at Hoag provides world class care for patients with specific conditions of the brain and spine such as stroke, aneurysms and vascular malformations, brain tumors, epilepsy, movement disorders, memory and cognitive disorders, pain, minimally invasive spine surgery, multiple sclerosis, addiction medicine and sleep disorders, as well as the mind-body interface of mental health. Many of Hoag’s PFNI programs have received high acclaim.The Hoag Stroke Program was the first in Orange County and the second in California to be named a Certified Comprehensive Stroke Center by DNV GL Healthcare and was awarded the American Stroke Association’s Get With The Guidelines Stroke Gold Plus Performance Achievement for stroke care. And as one of the first centers in the U.S. to offer the most advanced radiosurgical treatment system available, Leksell Gamma Knife® Perfexion™, the PFNI brain tumor program is the largest in Orange County and is also among the top volume programs in the western United States. Hoag has been recognized as a designated Level 4 Comprehensive Epilepsy Center by the National Association of Epilepsy Centers. The PFNI’s memory and cognitive disorders program is nationally recognized.

Hoag is a nonprofit, regional health care delivery network in Orange County, California, that treats more than 30,000 inpatients and 480,000 outpatients annually. Hoag consists of two acute-care hospitals – Hoag Hospital Newport Beach, which opened in 1952, and Hoag Hospital Irvine, which opened in 2010 – in addition to nine health centers and 13 urgent care centers. Hoag has invested $261 million in programs and services to support the underserved community within the past five years, including areas like mental health, homelessness, transportation for seniors, education, and support for single mothers. Hoag is a designated Magnet® hospital by the American Nurses Credentialing Center (ANCC). Hoag offers a comprehensive blend of health care services that includes five institutes providing specialized services in the following areas: cancerheart and vascularneuroscienceswomen’s health, and orthopedics through Hoag’s affiliate, Hoag Orthopedic Institute, which consists of an orthopedic hospital and two ambulatory surgical centers. In the 2020 – 2021 U.S. News & World Report Best Hospitals Rankings, Hoag is the highest ranked hospital in Orange County and the only OC hospital ranked in the Top 10 in California. For an unprecedented 23 years, residents of Orange County have chosen Hoag as one of the county’s best hospitals in a local newspaper survey. Visit www.hoag.org for more information.

SOURCE Hoag Memorial Hospital Presbyterian

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