Dave Clark, MD, PhD, Child and Adolescent Neurology, Epilepsy at Dell Children's Medical Center

Dell Children's is the only level 4 comprehensive pediatric epilepsy center in Central Texas

A team of neurosurgeons at Dell Children's Comprehensive Pediatric Epilepsy Center in Austin, Texas, reduce a baby’s seizures with LITT procedure.

At Dell Children's Pediatric Comprehensive Epilepsy Center, innovation and personalized treatment are changing the future for the very youngest patients.

The center, a joint collaboration with UT Health Austin, the clinical practice of Dell Medical School at The University of Texas at Austin, is committed to innovative research that leads to developing new, effective treatments. 

Such initiatives include a patient-centered approach to diagnosis and treatment, which have earned the Dell Children's Pediatric Comprehensive Epilepsy Center a Level 4 Epilepsy Center designation by the National Association of Epilepsy Centers. This recognition acknowledges our professional expertise and outstanding facilities that provide the highest medical and surgical evaluation and treatment for children with complex epilepsy.

Transforming care with new treatments and research

Doctors at the center, which is part of UT Health Austin Pediatric Neurosciences at Dell Children's, use a recent treatment breakthrough called laser interstitial thermal therapy (LITT) to help their patients better control seizures. 

LITT is increasingly used as a surgical option for the treatment of epilepsy. A pioneering team of scientist physicians, led by Dave F. Clarke, MD, Chief of the Pediatric Comprehensive Epilepsy Center and Elizabeth C. Tyler-Kabara MD, PhD performed LITT in a 4-month-old infant with poorly controlled focal seizures.

This care team overcame the challenges of using this technique in children under age 2. A previous concern for using LITT on young children was that the skull maturity at that age does not allow adequate stabilization of the laser fibers. This meant that young children could not benefit from this effective therapeutic intervention, which ultimately limits treatment options available to children under 2 with familial epilepsy syndromes, such as tuberous sclerosis complex (TSC). 

To adapt the LITT procedure for treatment of their young patient, the Dell Children’s Comprehensive Epilepsy Center team of doctors repurposed the Stealth™ Navigus™ biopsy skull mount for stereotactic placement of a laser fiber using electromagnetic-based navigation. It was revealed that the modified LITT can be done with commonly available tools and without dedicated instrumentation beyond standard stereotactic navigation, a biopsy platform, and the Visualase™ system.

Results of the surgical intervention, as described in their manuscript published in the Journal of Neurosurgery titled “MRI-guided laser interstitial thermal therapy using the Visualase system and Navigus frameless stereotaxy in an infant: technical case report,” revealed that the infant remained seizure-free for four months after the operation. 


About Dell Children’s Pediatric Comprehensive Epilepsy Center and Dell Children’s Medical Center

The Dell Children’s Comprehensive Epilepsy Center serves Central Texas as well as children from surrounding states who need advanced care. Dell Children’s has the only dedicated pediatric Epilepsy Monitoring Unit (EMU) in Central Texas and features the most advanced diagnostic and treatment options for pediatric epilepsy . The multidisciplinary epilepsy team and state-of-the-art EMU utilizes a patient-centered approach that includes the patient and family in decision making and coordinates an individualized plan of care that maximizes functional and quality-of-life outcomes. That includes everything from advanced diagnostic testing for neuropsychology, functional MRI, and magnetoencephalography (MEG) to a ketogenic diet, vagus nerve stimulation and epilepsy surgery.