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Deep brain stimulation for drug-resistant epilepsy.

Michael C H Li1, Mark J Cook1

  • 1The Graeme Clark Institute, University of Melbourne, Parkville, Vic., Australia.

Epilepsia
|December 9, 2017
PubMed
Summary

Deep brain stimulation (DBS) effectively reduces refractory epilepsy seizures, with anterior thalamus and hippocampus targets showing significant efficacy. Further trials are needed to optimize parameters and identify predictors of patient response.

Keywords:
efficacyintractablepredictorsrefractoryseizures

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Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Drug-resistant epilepsy poses significant challenges to patient quality of life.
  • Deep brain stimulation (DBS) is an emerging therapeutic option for refractory epilepsy.
  • Understanding the efficacy and influencing factors of DBS is crucial for clinical application.

Purpose of the Study:

  • To review clinical evidence on the antiepileptic effects of deep brain stimulation (DBS) for drug-resistant epilepsy.
  • To evaluate the safety of DBS therapy in epilepsy patients.
  • To identify factors influencing individual outcomes and response to DBS.

Main Methods:

  • Comprehensive literature search of PubMed and Medline databases.
  • Inclusion of articles investigating DBS for drug-resistant epilepsy.
  • Reference list screening to identify additional relevant studies.

Main Results:

  • Anterior nucleus of the thalamus (ANT) and hippocampus (HC) stimulation significantly reduce refractory seizures, with 46%-95% seizure reduction reported.
  • Approximately 75% of patients receiving ANT, HC, or centromedian nucleus of the thalamus (CMT) stimulation are responders (≥50% seizure reduction).
  • Potential predictors of efficacy include absence of structural abnormalities and precise electrode placement; specific targets show promise for certain seizure types.

Conclusions:

  • DBS, particularly ANT and HC stimulation, demonstrates significant antiepileptic effects for drug-resistant epilepsy.
  • Patient, disease, and stimulation factors may predict seizure outcomes.
  • Larger clinical trials are necessary to refine DBS parameters, indications, and predictive markers.