Patient-detectable responsive neurostimulation as a seizure warning system.
Patient-detectable responsive neurostimulation as a seizure warning system.
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DOI：
10.1111/epi.16933
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发表时间：
2021-07
期刊：
影响因子：
5.6
通讯作者：
Hirsch LJ
中科院分区：
文献类型：
--
作者：
Quraishi IH;Hirsch LJ
许多癫痫患者没有意识到他们的癫痫发作或没有可靠的先兆。反应性神经刺激系统（RNS）提供由颅内癫痫样活动触发的刺激。如果癫痫样模式持续，RNS重复刺激每次事件多达五次。RNS可引起急性刺激相关症状，可通过减少刺激来避免。由于五种疗法中的每一种都可以独立编程，因此可以对后一种疗法进行编程以诱导癫痫发作警告。本研究的目的是确定多大比例的患者可以通过刺激安全地引起可耐受的症状，最终用于主观癫痫发作识别。在18例患者中，12例（67%）有诱发症状，11例可耐受。光幻视最为常见。我们还介绍了一个病人，其中第五种疗法是为了诱导早期识别和治疗局灶性意识障碍癫痫发作，这是以前未被识别，并导致了几天的致残性认知障碍的症状。该协议在几年内都无法成功禁用群集。研究结果表明，RNS可以提供癫痫发作警告，潜在地提高安全性和生活质量，并导致预防特定患者的临床癫痫发作或群集。
Many people with epilepsy are not aware of their seizures or do not have reliable auras. The responsive neurostimulation system (RNS) delivers stimulation triggered by intracranial epileptiform activity. If an epileptiform pattern continues, RNS repeats stimulation up to five times per event. RNS can cause acute stimulation-related symptoms that can be avoided by reducing stimulation. Because each of the five therapies can be programmed independently, it may be possible to program the latter therapies to induce a seizure warning. The goal of this study was to determine what proportion of patients could have tolerable symptoms safely elicited by stimulation, ultimately for the purpose of subjective seizure recognition. Of 18 patients, 12 (67%) had induced symptoms, tolerable in 11. Phosphenes were most common. We also present one patient in whom the fifth therapy was set to induce a symptom for early recognition and treatment of clusters of focal impaired awareness seizures, which were previously unrecognized and had led to days of disabling cognitive impairment. This protocol prevented disabling clusters successfully for several years. The findings suggest RNS can provide a seizure warning, potentially improving safety and quality of life, and leading to prevention of clinical seizures or clusters in select patients.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
Epilepsy & behavior : E&B
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DOI：
10.1016/j.yebeh.2020.107327
发表时间：
2020-11
期刊：
Epilepsy & behavior : E&B
影响因子：
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