Case Report: Responsive Neurostimulation of the Centromedian Thalamic Nucleus for the Detection and Treatment of Seizures in Pediatric Primary Generalized Epilepsy.
Case Report: Responsive Neurostimulation of the Centromedian Thalamic Nucleus for the Detection and Treatment of Seizures in Pediatric Primary Generalized Epilepsy.
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DOI：
10.3389/fneur.2021.656585
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发表时间：
2021
影响因子：
3.4
通讯作者：
Abel TJ
中科院分区：
文献类型：
--
作者：
Welch WP;Hect JL;Abel TJ
高达20%的原发性全身性癫痫（PGE）患儿对癫痫发作控制药物没有有效反应。反应性神经刺激（RNS）是一种很有前景的治疗小儿耐药癫痫的方法，已被证明是一种有效的治疗方法，可以降低成人患者的癫痫发作频率和严重程度。丘脑中央核的RNS可能有助于防止PGE患者在癫痫发作活动期间的意识丧失。在这里，我们报告了一位16岁的男性，患有耐药PGE并伴有失神性癫痫发作，其特征是脑电图上的3hz尖波和慢波放电，他在双侧正中核RNS后癫痫发作频率降低了75%。在植入后6个月，该患者报告基线每日无癫痫活动完全消失，从每月3-4次全身性惊厥发作减少到每月1次。RNS记录显示，双侧CM核中有形成良好的3hz尖峰波放电，进一步支持了在CM中可以检测到临床相关的PGE急症放电的观点。本报告证明CM RNS可以检测到与pge相关的CM核癫痫发作，并提供治疗性刺激。
Up to 20% of pediatric patients with primary generalized epilepsy (PGE) will not respond effectively to medication for seizure control. Responsive neurostimulation (RNS) is a promising therapy for pediatric patients with drug-resistant epilepsy and has been shown to be an effective therapy for reducing seizure frequency and severity in adult patients. RNS of the centromedian nucleus of the thalamus may help to prevent loss of awareness during seizure activity in PGE patients with absence seizures. Here we present a 16-year-old male, with drug-resistant PGE with absence seizures, characterized by 3 Hz spike-and-slow-wave discharges on EEG, who achieved a 75% reduction in seizure frequency following bilateral RNS of the centromedian nuclei. At 6-months post-implant, this patient reported complete resolution of the baseline daily absence seizure activity, and decrease from 3–4 generalized convulsive seizures per month to 1 per month. RNS recordings showed well-formed 3 Hz spike-wave discharges in bilateral CM nuclei, further supporting the notion that clinically relevant ictal discharges in PGE can be detected in CM. This report demonstrates that CM RNS can detect PGE-related seizures in the CM nucleus and deliver therapeutic stimulation.
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影响因子：
3.4
作者：
Carney PW;Jackson GD
通讯作者：
Jackson GD
影响因子：
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作者：
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通讯作者：
Blumenfeld, H
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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通讯作者：
Shields, W. Donald
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作者：
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通讯作者：
Mariani, Pedro Paulo