Implantation of a responsive neurostimulator device in patients with refractory epilepsy
Implantation of a responsive neurostimulator device in patients with refractory epilepsy
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DOI：
10.3171/foc/2008/25/9/e12
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发表时间：
2008-09-01
影响因子：
4.1
通讯作者：
Jallo, George I.
中科院分区：
文献类型：
--
作者：
Anderson, William S.;Kossoff, Eric H.;Jallo, George I.
对象。作者总结了一个中心使用一种用于治疗癫痫发作的新型装置——反应性神经刺激（RNS）系统的经验，并提供了有关植入过程的技术细节。作者回顾了7例植入RNS系统的患者的癫痫发作检测、皮质刺激和临床数据。提供了前4例植入物治疗患者癫痫发作改变的数据。本文包括1例枕叶异位患者的植入术。基于患者的癫痫发作日记，植入的装置对临床癫痫发作检测具有很高的灵敏度。根据他们的日记和诊所随访记录，癫痫发作频率降低了50%至75%。没有观察到不良刺激引起的副作用，也没有发生需要外植的硬件故障。3例患者在11个月、17个月和20个月时因电池耗尽需要更换发电机。植入过程耐受性良好，术后住院时间短。第一例患者因颅骨缺损行颅骨翻修成形术，其病例将作详细讨论。在这个小的初步系列中获得的结果证明了反应性神经刺激装置的安全植入方法。
Object. The authors summarize one center's experience with a novel device, the Responsive Neurostimulation (RNS) system, which is used to treat seizures, and they provide technical details regarding the implantation procedure.Methods. The authors reviewed seizure detection, cortical stimulation, and clinical data obtained in 7 patients in whom the RNS system was implanted. Data pertaining to seizure alteration are provided for the first 4 implant-treated patients. The implantation procedure in the case of one patient with occipital lobe heterotopia is included.Results. Based on patients' seizure diaries, the implanted devices functioned at a high sensitivity for clinical seizure detection. Reductions in seizure frequency, based on their diaries and on clinic follow-up notes, ranged from 50 to 75%. No adverse stimulation-induced side effects were noted, and no hardware malfunctions requiring explantation occurred. Generator replacements for battery depletion were required at 11, 17, and 20 months in 3 patients. The implantation procedure was well tolerated, and postoperative hospital stays were short. A revision cranioplasty for a skull defect was performed in the index patient, whose case will be discussed in the most detail.Conclusions. The results obtained in this small preliminary series demonstrate a safe implantation method for the responsive neurostimulation device.