特集 脳神経外科医が知っておきたい-てんかんのすべて Ⅳ 脳神経外科医が知っておきたいてんかん治療 植え込み型電気刺激療法

特集 脳神経外科医が知っておきたい-てんかんのすべて Ⅳ 脳神経外科医が知っておきたいてんかん治療 植え込み型電気刺激療法
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专题:神经外科医生需要了解的关于癫痫的一切 Ⅳ 神经外科医生需要了解的癫痫治疗:植入式电刺激疗法

DOI:
10.11477/mf.1436204725
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发表时间:
2023
期刊:
Neurological Surgery 脳神経外科
影响因子:
--
通讯作者:
菅野 秀宣
菅野 秀宣
中科院分区:
--
文献类型:
--
作者:
松田勇輝;平松匡文;杉生憲志;木村 颯;山岡陽子;胡谷侑貴;佐藤 悠;西 和彦;村井 智;春間 純;菱川朋人;伊達 勲;菅野 秀宣

文献摘要

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癫痫的神经调节治疗是继内科抗癫痫药物治疗和癫痫灶切除等外科治疗之后的第三种治疗选择。除了迷走神经刺激(VNS),脑深部刺激(DBS)和反应性神经刺激(RNS)已经在几个国家获得批准。这些疗法由植入式装置和刺激电极组成。这些治疗方法在降低癫痫发作频率和严重程度、提高患者的生活质量和维持治疗效果方面具有很大潜力。当第一次引入VNS时,电刺激被设置为规则的间隔。然而,目前的设备已经引入了闭环系统治疗,其中刺激是通过检测癫痫发作来进行的。VNS中还引入了多模式刺激设置,以根据一天中最有可能发生癫痫的时间调整患者的癫痫发作特征。根据最近的研究报告,本文综述了治疗癫痫的第三种治疗方法。
Neuromodulation therapy for epilepsy is the third treatment option after medical treatment with antiepileptic drugs and surgical treatment, such as epileptic focal resection. In addition to vagus nerve stimulation(VNS), deep brain stimulation(DBS)and responsive neurostimulation(RNS)have been approved in several countries. These therapies consist of an implantable device and stimulating electrodes. These therapies have great potential to reduce seizure frequency and severity, improve patients' quality of life, and maintain therapeutic efficacy. When VNS was first introduced, electrical stimulation was set at regular intervals. However, current devices have introduced closed-loop therapy, in which stimulation is performed by detecting seizures. Multi-mode stimulation settings have also been introduced in VNS to adjust patient's seizure characteristics based on the time of the day when seizures are most likely to occur. This review describes the third therapeutic approach for the treatment of epilepsy based on recent research reports.