Burning seizures away: Laser ablation gives a teen his life back

When high school sophomore Justin Griffin was about four months old, he began having lapses in his breathing. He was having seizures that were discovered to be caused by a brain tumor. Boston Children’s Hospital neurosurgeon Joseph Madsen, MD, removed the tumor. All seemed to be well.

But in middle school, Justin’s seizures started up again. They were caused by a small lesion—a pocket of abnormal tissue—that had developed near the location of the original tumor. His neurologist prescribed a series of anti-epileptic medications.

“He would be on a medicine for a while and it would seem to be working, and then he would start having seizures again,” says his mother, Keren. “The neurologist said that usually after three or four medicines when you fail, that’s when they start talking about other options, and one of them would be surgery. I said, ‘I don’t want to open up his head again. Isn’t there anything else we can do?’”

New treatment for seizures: laser ablation

It turned out there was: Madsen, director of Epilepsy Surgery at Boston Children’s, had recently begun offering a new, minimally invasive laser operation and took Justin on as one of his early cases. Because Justin’s seizures were originating from a discrete, identifiable spot in his brain, he was a good candidate for the procedure, known as laser ablation.

The neurosurgical team first placed a frame on Justin’s head, containing a set of markers that acted like a GPS system. These coordinates would help Madsen navigate a safe path to the lesion, bypassing healthy parts of the brain.

Next, an applicator tube about the width of a strand of spaghetti—tipped by the laser—was inserted through a small hole drilled in Justin’s scalp and advanced to the site of the lesion, guided by magnetic resonance imaging (MRI).

Then Madsen turned the laser on. He used the MRI signal to keep close tabs on the temperature, allowing him to safely dial up the heat and ensure that only the lesion was being heated, not the surrounding tissue.

20130329_LaserAblation-17PreviewlargeThe team then reviewed the MRI images again: The heat of the laser had successfully killed—ablated—the abnormal tissue.

Justin left Boston Children’s the next day. “By the time we got home, Justin wanted to be out and doing things,” says Keren. “The hardest part of the recovery for me was holding him back a little bit.” Four days later, Justin was back in school.

Justin has now been seizure-free for more than eight months and completed his first year of high school this spring. Read about his laser procedure in detail in the Boston Globe and on Boston Children’s Neurosurgery website.