NHS launches laser beam brain surgery to treat epilepsy

A world-leading, fibre optic laser therapy for people suffering with epilepsy who have not responded well to other forms of treatment will be rolled out on the NHS.

Offering hope to thousands of current and future NHS patients, the cutting-edge laser treatment, targets the part of the brain that is causing the seizures without the need for invasive surgery.

A nationwide first, the treatment will benefit up to 150 NHS patients every year with the first surgeries set to take place in early 2023.

The laser requires just a 1.5mm-wide probe into the skull with the fibre optic laser at the tip of the probe reaching and destroying the epilepsy-causing brain tissue from the inside by heating it.

Carried out in an MRI scanner, the clinical team accurately navigate through the brain avoiding blood vessels and other critical structures, and can monitor the temperature of the surrounding areas to ensure healthy brain tissue does not overheat.

The small wound heals quickly meaning patients can go home the next day with minimal risk of infection or other side effects and can return to their usual work and activities within a week.

This is the latest example of the NHS delivering on the Long Term Plan commitment to ensure patients across the country have access to the latest and most effective treatments available.

NHS national medical director Professor Sir Stephen Powis said: “This pioneering laser beam treatment for epilepsy patients is life-changing and will offer hope to hundreds of people every year who have not had success in preventing seizures with traditional drugs.

“By replacing invasive neurosurgery with a cutting-edge laser therapy, allowing clinicians to better target the parts of the brain causing the epilepsy, we not only dramatically reduce risks to these patients, but drastically reduce their recovery time both in and out of hospital.

“The treatment is yet another example of how the NHS continues to deliver on its NHS Long Term Plan commitment to secure the latest medical innovations for patients while also using our commercial means to ensure value for money”.

Currently one in three people with epilepsy are not able to control their seizures with drugs alone and may require invasive neurosurgery to remove the epilepsy-causing part of the brain.

Around one in 100 people suffer with epilepsy and there are around 600,000 people living with the condition across the UK.

While as many as 150,000 people may experience seizures of some kind, only around 10,000 are candidates for conventional surgery. This may be because the source of the seizure is not able to be localised or the seizures are not frequent or intense enough – and just one in 10 of these people are likely to go ahead with neurosurgery.

Current conventional neurosurgery – an invasive operation on the skull and brain, removing the part that is causing the seizures – is only considered in patients who have had limited success with other treatments. It requires a week’s stay in hospital, followed by three months of recovery at home, which carries risks of infection and pain.

NHS medical director for specialised services Professor James Palmer said: “This innovative laser therapy is a game-changing breakthrough for patients who have not had success with traditional forms of treatment to control their seizures and will give those with epilepsy a real chance to live a normal life.

“The NHS is committed to rolling out cutting-edge treatments as quickly as possible – it is just one of seven new innovations that the NHS is making available to patients from today across the country following the latest review of treatments and technologies that should be prioritised for investment.”

LITT will initially be available at two specialist service providers in England with the first surgeries beginning in early 2023.

Individuals eligible for this treatment will have focal epilepsy that has not been controlled with two or more appropriate anti-seizure medications at maximum tolerated doses and have been investigated at an Epilepsy Surgery Centre.

They will also have their suitability assessed by a multi-disciplinary team and have a form of epilepsy that would make open neurosurgery highly risky.

This new treatment is one of seven recommendations made by the Clinical Priorities Advisory Group (CPAG) that NHS England has accepted because the treatments are effective and represent an improvement in the service offered to patients.