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Articles linked to this work by shared authors, journal, and citation graph.

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Information needs of patients considering epilepsy surgery: A scoping review.

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Epilepsy and Neuromodulation-Randomized Controlled Trials.

Churl-Su Kwon1,2,3, Valeria Ripa4, Omar Al-Awar5

  • 1Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. churlsu.kwon@mssm.edu.

Brain Sciences
|April 20, 2018
PubMed
Summary
This summary is machine-generated.

Neuromodulation offers a treatment for drug-resistant epilepsy when surgery isn't an option. While reducing seizures is common, achieving complete seizure freedom remains rare across various neurostimulation methods.

Keywords:
deep brain stimulation (DBS)epilepsyexternal trigeminal nerve stimulation (eTNS)neuromodulationrandomized clinical trials (RCT)repetitive transcranial magnetic stimulation (rTMS)responsive neurostimulation (RNS)transcranial direct current stimulation (tDCS)vagal nerve stimulation (VNS)

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Neuromodulation is a growing treatment for drug-resistant epilepsy, particularly for patients unsuitable for resective surgery.
  • Established invasive neuromodulation techniques include deep brain stimulation (DBS), vagus nerve stimulation (VNS), and responsive neurostimulation (RNS).
  • Non-invasive methods like transcranial direct current stimulation (tDCS), electrical transcranial stimulation (eTNS), and repetitive transcranial magnetic stimulation (rTMS) show promise.

Purpose of the Study:

  • To review double-blinded randomized clinical trials (RCTs) evaluating neuromodulation for epilepsy.
  • To assess the efficacy and limitations of both invasive and non-invasive neuromodulation techniques in epilepsy management.

Main Methods:

  • Systematic review of double-blinded randomized clinical trials (RCTs) on neuromodulation in epilepsy.
  • Analysis of reported seizure frequency reduction and seizure freedom rates.
  • Evaluation of targeting strategies, side effects, and cost-effectiveness.

Main Results:

  • Neuromodulation, including DBS, VNS, and RNS, is approved and shows efficacy in reducing seizure frequency.
  • Seizure freedom is rarely achieved with current neuromodulation therapies.
  • Non-invasive methods like tDCS, eTNS, and rTMS require larger, powered studies and improved targeting.

Conclusions:

  • Neuromodulation is a viable option for drug-resistant epilepsy, but further research is needed.
  • Optimizing targeting, minimizing side effects, and improving cost-effectiveness are crucial for invasive techniques.
  • Larger, well-designed studies are necessary to validate the efficacy of non-invasive neuromodulation for epilepsy.