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Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
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Neuromodulation techniques for status epilepticus: A review.

Daniel San-Juan1, Daniel Oswaldo Dávila-Rodríguez1, Christian Ramos Jiménez2

  • 1Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.

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|May 5, 2019
PubMed
Summary

Neuromodulation therapies like Electroconvulsive therapy (ECT) and Vagal Nerve Stimulation (VNS) show high efficacy in treating Status Epilepticus (SE). Further research is needed to understand the safety and efficacy balance of these treatments.

Keywords:
Deep brain stimulationElectroconvulsive therapyRefractory status epilepticusStatus epilepticusTranscranial magnetic stimulationVagal nerve stimulation

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Area of Science:

  • Neurology
  • Neurosurgery
  • Neuroscience

Background:

  • Status Epilepticus (SE) is a neurological emergency.
  • Neuromodulation therapies including Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS), and Deep Brain Stimulation (DBS) have been explored for SE treatment.

Purpose of the Study:

  • To conduct a literature review on the efficacy and safety of neuromodulation therapies for Status Epilepticus in human patients.

Main Methods:

  • A comprehensive literature search was performed across PubMed, Scopus, Google Scholar, and Science Direct up to June 2018.
  • Four independent reviewers selected studies, extracted data, and assessed methodological quality using established guidelines (Cochrane, PRISMA, Oxford, GRADE).

Main Results:

  • Analysis of 27 articles involving 45 patients revealed varying efficacy and safety profiles for different neuromodulation techniques.
  • Electroconvulsive therapy (ECT) demonstrated an 80% SE disruption rate with 5% adverse events.
  • Intravenous Vagal Nerve Stimulation (iVNS) resolved SE in 93.7% of patients.
  • Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) both aborted SE in all treated patients, though DBS was associated with a 50% rate of severe adverse events.

Conclusions:

  • Current evidence from case series and reports suggests neuromodulation therapies can effectively abort Status Epilepticus in 80-100% of patients.
  • A wide range of adverse effects necessitates further prospective studies to establish a clear relationship between efficacy and safety.