Low and High Frequency Hippocampal Stimulation for Drug-Resistant Mesial Temporal Lobe Epilepsy.
Low and High Frequency Hippocampal Stimulation for Drug-Resistant Mesial Temporal Lobe Epilepsy.
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DOI：
10.1111/ner.12435
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发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
Wu T
中科院分区：
文献类型：
--
作者：
Lim SN;Lee CY;Lee ST;Tu PH;Chang BL;Lee CH;Cheng MY;Chang CW;Tseng WE;Hsieh HY;Chiang HI;Wu T
海马体的电刺激为治疗不适合手术的内侧颞叶癫痫 (MTLE) 患者提供了可能性。我们报告了 5 名接受低频或高频海马刺激治疗耐药 MTLE 的患者的长期随访结果。患者在海马体中接受四极刺激电极的立体定向植入。其中两名患者接受单侧电极植入，另外三名患者接受双侧电极植入。植入植入式脉冲发生器后立即开启海马电极刺激，初始刺激参数为：1 V、90-150 μs、5 或 145 Hz。监测癫痫发作频率并与植入前基线数据进行比较。研究对象为两名男性和三名女性，年龄为 27-61 岁，平均随访期为 38.4 个月（范围为 30-42 个月）。基线癫痫发作频率为 2.0-15.3 次/月。在研究期间，海马刺激后，五名患者的癫痫发作频率平均减少了 45%（范围 22-72%）。低频海马刺激降低了两名患者的癫痫发作频率（分别降低了 54% 和 72%）。没有报告与植入或刺激相关的副作用。海马电刺激是一种微创且可逆的方法，可以改善耐药 MTLE 患者的癫痫发作结果。最佳刺激频率因患者而异，因此需要单独设置。这些实验结果需要对大量患者进行进一步的对照研究，以评估不同刺激参数的海马刺激的长期效果。
Electrical stimulation of the hippocampus offers the possibility to treat patients with mesial temporal lobe epilepsy (MTLE) who are not surgical candidates. We report long‐term follow‐up results in five patients receiving low or high frequency hippocampal stimulation for drug‐resistant MTLE. The patients underwent stereotactic implantation of quadripolar stimulating electrodes in the hippocampus. Two of the patients received unilateral electrode implantation, while the other three received bilateral implantation. Stimulation of the hippocampal electrodes was turned ON immediately after the implantation of an implantable pulse generator, with initial stimulation parameters: 1 V, 90–150 μs, 5 or 145 Hz. The frequency of seizures was monitored and compared with preimplantation baseline data. Two men and three women, aged 27–61 years were studied, with a mean follow‐up period of 38.4 months (range, 30–42 months). The baseline seizure frequency was 2.0–15.3/month. The five patients had an average 45% (range 22–72%) reduction in the frequency of seizures after hippocampal stimulation over the study period. Low frequency hippocampal stimulation decreased the frequency of seizures in two patients (by 54% and 72%, respectively). No implantation‐ or stimulation‐related side effects were reported. Electrical stimulation of the hippocampus is a minimally invasive and reversible method that can improve seizure outcomes in patients with drug‐resistant MTLE. The optimal frequency of stimulation varied from patient to patient and therefore required individual setting. These experimental results warrant further controlled studies with a large patient population to evaluate the long‐term effect of hippocampal stimulation with different stimulation parameters.
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影响因子：
9.9
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