The effect of medial pulvinar stimulation on temporal lobe seizures
The effect of medial pulvinar stimulation on temporal lobe seizures
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DOI：
10.1111/epi.14677
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发表时间：
2019-04-01
期刊：
影响因子：
5.6
通讯作者：
Bartolomei, Fabrice
中科院分区：
文献类型：
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作者：
Filipescu, Cristina;Lagarde, Stanislas;Bartolomei, Fabrice
我们研究了电刺激内侧枕(PUM)对颞叶癫痫发作的影响。8例接受立体脑电探查的难治性颞叶癫痫患者。所有人都至少有一个电极在探测Pum。大多数受试者对高频(50赫兹)的PUM刺激耐受性良好。在诊断刺激以确定致痫区域的过程中，通过刺激海马体触发了19次癫痫发作。在其中一些癫痫发作中，对同侧枕叶进行刺激(130 Hz，脉冲宽度=450微秒，持续时间=3-7秒，1-2 mA)。与非PUM刺激的癫痫相比，8名患者中有5名在临床上经历了不那么严重的癫痫发作，特别是在意识改变的程度方面。在电水平上，阵挛发作更快，紧张期更短。这项概念验证研究首次表明，PUM刺激可能是一种耐受性良好的有效方法，用于治疗耐药癫痫的脑深部刺激。
We investigated the effect of electrical stimulation of the medial pulvinar (PuM) in terms of its effect on temporal lobe seizures. Eight patients with drug-resistant temporal lobe epilepsy undergoing stereoelectroencephalographic exploration were included. All had at least one electrode exploring the PuM. High-frequency (50 Hz) stimulations of the PuM were well tolerated in the majority of them. During diagnostic stimulation to confirm the epileptogenic zone, 19 seizures were triggered by stimulating the hippocampus. During some of these seizures, ipsilateral pulvinar stimulation was applied (130 Hz, pulse width = 450 microseconds, duration = 3-7 seconds, 1-2 mA). Compared to non-PuM-stimulated seizures, five of eight patients experienced clinically less severe seizures, particularly in terms of degree of alteration of consciousness. On the electrical level, seizures were more rapidly clonic with a shorter tonic phase. This proof of concept study is the first to suggest that PuM stimulation could be a well-tolerated and effective means of therapeutic deep brain stimulation in drug-resistant epilepsies.