Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus.
Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus.
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DOI：
10.1684/j.1950-6945.2002.tb00549.x
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发表时间：
2002-12
期刊：
影响因子：
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通讯作者：
S. Chabardès;P. Kahane;L. Minotti;A. Koudsié;E. Hirsch;A. Benabid
中科院分区：
文献类型：
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作者：
S. Chabardès;P. Kahane;L. Minotti;A. Koudsié;E. Hirsch;A. Benabid
正在开发用于治疗无法通过切除手术治疗的医学难治性癫痫患者的替代方法，例如慢性脑深部神经刺激。这种方法已被用于小脑，各种丘脑核，并在尾状核。在格勒诺布尔，鼓励的抑制作用的药理学或电抑制的癫痫动物模型中的不同类型的癫痫发作，并通过我们的经验，高频刺激（HFS）的运动障碍患者，我们已经评估了高频刺激丘脑底核（HFS）。在5名患有药物难治性癫痫发作并被认为不适合切除手术的患者中进行了HFS。在3名患者中观察到癫痫发作频率降低67%至80%，其中3名患者的中央区域存在部分症状性癫痫。另外一名患有严重肌阵挛性癫痫（Dravet综合征）的患者也对HFS有反应，癫痫发作频率降低较弱。第五例患有常染色体显性额叶癫痫伴岛额叶癫痫发作的患者没有显示出任何改善。这些结果表明，对于无法从传统手术中获益的耐药性癫痫患者，刺激小脑顶可能是一种有希望的治疗方法。
Alternative methods, for the treatment of medically refractory epileptic patients, who cannot be treated by resective surgery, such as chronic deep brain neurostimulation, are under development. Such methods have been used in the cerebellum, various thalamic nuclei, and in the caudate nucleus. In Grenoble, encouraged by the suppressive effects of pharmacological or electrical inhibition of the STN on different types of seizure in animal models of epilepsy, and by our experience with STN high frequency stimulation (HFS) in patients with movement disorders, we have evaluated the high frequency stimulation of the subthalamic nucleus (STN HFS). STN HFS was performed in five patients suffering from medically intractable seizures and considered unsuitable for resective surgery. A 67% to 80% reduction in seizure frequency was observed in three patients, with a partial symptomatic epilepsy of the central region. An additional patient suffering from severe myoclonic epilepsy (Dravet syndrome) also responded to STN HFS, with a weaker reduction of seizure frequency. The fifth patient who suffered from an autosomal dominant frontal lobe epilepsy with insulo-frontal seizures did not show any improvement. These results suggest that stimulation of STN could be a promising treatment for patients with drug-resistant epilepsy who would not benefit from conventional surgery.