Effect of an external responsive neurostimulator on seizures and electrographic discharges during subdural electrode monitoring
Effect of an external responsive neurostimulator on seizures and electrographic discharges during subdural electrode monitoring
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DOI：
10.1111/j.0013-9580.2004.26104.x
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发表时间：
2004-12-01
期刊：
影响因子：
5.6
通讯作者：
Bergey, GK
中科院分区：
文献类型：
--
作者：
Kossoff, EH;Ritzl, EK;Bergey, GK
目的：已批准的癫痫神经刺激疗法使用长时间间歇性刺激模式，无法对癫痫发作自动做出反应。方法：在一项开放的多中心试验中，对 50 名患者进行了评估，其中包括 50 名患者，其中 40 名患者通过植入硬膜下电极接受了响应性皮质刺激，以进行癫痫手术评估。结果：4 名患者，年龄 15 岁至 15 岁。描述了 28 年在三个机构监测的临床和电图对神经刺激的反应。在持续小于或等于 8 小时的神经刺激试验中，这些患者的电图癫痫发作被改变和抑制，没有重大副作用。在一名患者中，刺激似乎也改善了基线脑电图。结论：反应性皮质神经刺激可能是部分性癫痫的安全有效的治疗方法。该信息来自一项观察研究中的一小群患者。一项经美国食品和药物管理局 (FDA) 批准的双盲、受控研究正在进行中，研究永久植入的反应性神经刺激系统用于治疗医学难治性部分性癫痫发作。
Purpose: Approved neural-stimulation therapies for epilepsy use prolonged intermittent stimulation paradigms with no ability to respond automatically to seizures.Methods: A responsive neurostimulator that can automatically analyze electrocortical potentials, detect electrographic seizures, and rapidly deliver targeted electrical stimuli to suppress them was evaluated in an open multicenter trial in 50 patients, 40 of whom received responsive cortical stimulation via subdural electrodes implanted for epilepsy surgery evaluations.Results: Four patients, ages 15 to 28 years, monitored at three institutions, with clinical and electrographic response to neurostimulation, are described. Electrographic seizures were altered and suppressed in these patients during trials of neurostimulation lasting less than or equal to8 h, with no major side effects. In one patient, stimulation appeared also to improve the baseline EEG.Conclusions: Responsive cortical neurostimulation may be a safe and effective treatment for partial epilepsy. This information was derived from a small group of patients in an observation study. A double-blind, controlled Food and Drug Administration (FDA)-approved study of a permanently implanted responsive neurostimulation system to treat medically refractory partial seizures is under way.