Before the Procedure

Before LITT, you’ll undergo testing to determine that you’re a good candidate for the treatment. Neurologists, neurosurgeons and neuropsychologists will review these tests, which may include:

• CT scan, which uses special computers and X-rays to get a clear image of your brain 
• Electroencephalogram (EEG), which records your brain’s activity through small electrodes attached to your scalp 
• High-density EEG, which identifies where seizures may originate in your brain 
• MRI, which uses magnets and radio waves to get a brain image 
• Neuropsychological exams, which assess your thinking (cognitive) skills and behaviors to help identify dysfunctional areas of your brain
• Positron emission tomography (PET) scan, which uses a small injection called a radiotracer to get more information about your brain function 
• Single-photon emission computed tomography (SPECT) scan, which uses a radiotracer to evaluate your brain’s blood flow during a seizure 
• Stereoelectroencephalography (SEEG), which is a diagnostic surgical procedure to isolate the seizure focus from inside the brain tissue

Once we’ve determined LITT is right for you, you’ll have an MRI that helps plan surgery. During the MRI, we map out exactly which areas of brain tissue to target during treatment. 

During the Procedure

We perform LITT in an operating room with a special MRI machine called an intraoperative MRI. On the day of your treatment, you receive general anesthesia to remain asleep during the procedure. During LITT, your neurosurgeon:

1. Makes a small incision in your scalp about the size of a papercut
2. Drills a hole in your skull no larger than 5 millimeters, or about the width of a pencil 
3. Guides a small laser fiber through the incision and to the irregular tissue
4. Directs heat to the unhealthy brain tissue 
5. Uses real-time MRI guidance to monitor the laser location and temperature of your brain tissue
6. Closes the incision

LITT typically lasts around three to four hours. Your exact surgery time depends on several factors, including the size and shape of the tissue target and whether your surgeon needs to target more than one area. 

After the Procedure

Your care team moves you to a recovery room immediately after LITT. You usually stay in the hospital for one night and return home the next day.

Most people have minimal pain or discomfort. You can typically manage any pain with over-the-counter medicines. You can return to your usual activities within a day or two, but you will need to refrain from strenuous activities for about two weeks.