RNS modifications to eliminate stimulation-triggered signs or symptoms (STS): Case series and practical guide.
RNS modifications to eliminate stimulation-triggered signs or symptoms (STS): Case series and practical guide.
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DOI：
10.1016/j.yebeh.2020.107327
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Drees C
中科院分区：
文献类型：
--
作者：
Hixon AM;Brown MG;McDermott D;Destefano S;Abosch A;Kahn L;Ojemann S;Drees C
对于顽固性癫痫，响应性神经刺激(RNS)包括在大脑上或脑内放置电极，检测癫痫发作活动，然后在癫痫发作扩散之前提供电流以终止癫痫发作。成功的RNS治疗每天可以提供数百种刺激，而患者通常不会注意到这些刺激。不同寻常的是，RNS电极可能会刺激大脑区域或周围结构，导致不舒服的感觉或运动效应，我们称之为刺激触发的体征或症状(STS)。STS的发生可能会限制充分使用RNS以减少癫痫发作的能力。在这个病例系列中，我们描述了我们机构58名RNS患者中的6名(10.3%)的STS。为了消除或最小化STS，我们开发了一种修改RNS参数的协议。在所有6名患者中，修改RNS刺激与STS降低有关，其中5名患者调整了刺激设置，1名患者调整了导联位置。在症状减轻后，6名患者中有5名能够进一步优化RNS以改善癫痫控制。1例复发的STS阻止了RNS刺激电流的进一步增加。这项研究可能会帮助其他医疗团队识别和减少接受RNS设备的癫痫患者的STS。
Responsive neurostimulation (RNS) for intractable epilepsy involves placement of electrodes onto or into the brain that detect seizure activity and then deliver a current to abort a seizure before it spreads. Successful RNS treatment can deliver hundreds of stimulations per day, which are generally unnoticeable to patients. Uncommonly, RNS electrodes may result in stimulation of brain regions or peripheral structures that causes uncomfortable sensory or motor effects, a phenomenon we refer to as stimulation-triggered signs or symptoms (STS). Occurrence of STS may limit the ability to use RNS to full capacity to reduce seizures. In this case series, we describe STS in six out of 58 (10.3%) RNS patients at our institution. To eliminate or minimize STS, we developed a protocol for modification of RNS parameters. Modifying RNS stimulation was associated with reduced STS in all six patients, five had adjustment of stimulation settings, one of lead position. Five out of six patients were able to undergo further optimization of RNS for improved seizure control after reduction of symptoms. One patient had recurrent STS that prevented further increase of RNS stimulation current. This study may help other medical teams in identifying and reducing STS in patients with epilepsy receiving RNS devices.
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影响因子：
5.6
作者：
Kossoff, EH;Ritzl, EK;Bergey, GK
通讯作者：
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影响因子：
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影响因子：
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影响因子：
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作者：
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