Chronic anterior thalamus stimulation for intractable epilepsy
Chronic anterior thalamus stimulation for intractable epilepsy
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DOI：
10.1046/j.1528-1157.2002.26001.x
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发表时间：
2002-06-01
期刊：
影响因子：
5.6
通讯作者：
Lozano, AM
中科院分区：
文献类型：
--
作者：
Hodaie, M;Wennberg, RA;Lozano, AM
目的：尽管抗癫痫药物（AED）治疗，但大量癫痫患者仍控制不佳，不适合切除手术。需要新的治疗方法来减少这一人群的癫痫发作负担。一些观察表明，丘脑前区在癫痫发作的维持和传播中起着重要作用。我们研究了神经调制的前丘脑通过使用脑深部电刺激（DBS）在顽固性seizure.Methods患者：5例难治性癫痫患者进行立体定向放置和接受刺激，通过双边DBS电极在前thalamus.Results：治疗显示癫痫发作频率的统计学显着下降，平均减少54%（平均随访，15个月）。其中两名患者的癫痫发作减少大于或等于75%。DBS电极插入或刺激后未观察到不良反应。出乎意料的是，所观察到的好处并没有不同的刺激和刺激关闭periods.Conclusions：DBS的前丘脑是一个安全的程序，并可能有效的药物抵抗癫痫发作的患者。
Purpose: A significant number of patients with epilepsy remain poorly controlled despite antiepileptic medication (AED) treatment and are not eligible for resective surgery. Novel therapeutic methods are required to decrease seizure burden in this population. Several observations have indicated that the anterior thalamic region plays an important role in the maintenance and propagation of seizures. We investigated neuromodulation of the anterior thalamus by using deep-brain stimulation (DBS) in patients with intractable seizures.Methods: Five patients with medically refractory epilepsy underwent stereotactic placement of and received stimulation through bilateral DBS electrodes in the anterior thalamus.Results: Treatment showed a statistically significant decrease in seizure frequency, with a mean reduction of 54% (mean follow-up, 15 months). Two of the patients had a seizure reduction of greater than or equal to75%. No adverse effects were observed after DBS electrode insertion or stimulation. Unexpectedly, the observed benefits did not differ between stimulation-on and stimulation-off periods.Conclusions: DBS of the anterior thalamus is a safe procedure and possibly effective in patients with medically resistant seizures.