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External trigeminal nerve stimulation for drug resistant epilepsy: A randomized controlled trial
Francisco Gil-López1, Teresa Boget2, Isabel Manzanares1
1Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain, Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
Brain Stimulation
|June 14, 2020
Summary
External trigeminal nerve stimulation (ETNS) effectively reduces seizure frequency in focal drug-resistant epilepsy (DRE). This non-invasive therapy showed significant long-term benefits and good tolerability, particularly in temporal epilepsy.
Area of Science:
- Neurology
- Neuroscience
- Medical Devices
Background:
- External trigeminal nerve stimulation (ETNS) is an emerging non-invasive neurostimulation therapy.
- Previous studies suggest ETNS can decrease seizure frequency in focal drug-resistant epilepsy (DRE).
Purpose of the Study:
- To evaluate the long-term efficacy and tolerability of ETNS in focal DRE patients.
- To investigate if ETNS efficacy varies by epileptogenic zone (frontal vs. temporal).
- To assess ETNS impact on mood, cognition, quality of life, and trigeminal nerve excitability.
Main Methods:
- Forty patients with frontal or temporal DRE, ineligible for surgery, were randomized to ETNS or standard medical care.
- Evaluations included seizure frequency, side effects, mood scales, neuropsychological tests, and trigeminal nerve excitability at 3, 6, and 12 months.
Main Results:
- At 12 months, 50% of the ETNS group responded versus 0% in the control group, with a -43.5% median seizure frequency reduction.
- Temporal epilepsy patients showed a better response (55.56%) than frontal epilepsy patients (45.45%).
- ETNS improved quality of life without adverse effects on mood, cognition, or nerve excitability.
Conclusions:
- ETNS is an effective and well-tolerated treatment for focal DRE.
- Response to ETNS may be more pronounced in patients with temporal epilepsy.
- Further research with larger cohorts is needed to compare ETNS with other neurostimulation techniques.
