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Intracranial stimulation for children with epilepsy
Antonio Valentín1, Richard P Selway2, Meriem Amarouche2
1Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Clinical Neurophysiology, King's College Hospital NHS Trust, London, UK.
Summary
Intracranial stimulation, including subacute cortical stimulation (SCS) and deep brain stimulation (DBS), shows promise for treating refractory epilepsy in children. Most patients experienced significant seizure reduction with well-tolerated procedures.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Epileptology
Background:
- Refractory epilepsy in children poses significant treatment challenges.
- Intracranial electrical stimulation is an emerging therapeutic option.
Purpose of the Study:
- To assess the efficacy and tolerability of intracranial stimulation for pediatric refractory epilepsy.
- To evaluate both subacute cortical stimulation (SCS) and deep brain stimulation (DBS).
Main Methods:
- Retrospective analysis of 8 children with refractory epilepsy undergoing intracranial stimulation (2014-2015).
- Five children received SCS; three received DBS (centromedian or anterior nucleus).
- Efficacy measured by seizure frequency, severity, and interictal discharge reduction.
Main Results:
- Four of five children (80%) with SCS showed >50% seizure reduction.
- Two of three children (67%) with DBS experienced >60% improvement in seizures.
- Procedures were well-tolerated in all pediatric participants.
Conclusions:
- Cortical and thalamic stimulation are effective and safe for pediatric refractory epilepsy.
- SCS aids in identifying seizure foci and predicting surgical outcomes.
- Larger studies are warranted to confirm these findings.
