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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Neurostimulation for childhood epilepsy.

Ann Mertens1, Paul Boon1,2, Kristl Vonck1

  • 1Department of Neurology, 4Brain, Ghent University Hospital, Ghent, Belgium.

Developmental Medicine and Child Neurology
|July 14, 2023
PubMed
Summary
This summary is machine-generated.

Neurostimulation offers valuable options for managing childhood epilepsy, with Vagus Nerve Stimulation (VNS) showing similar safety and efficacy to adults. Other methods like deep brain stimulation (DBS) and responsive neurostimulation (RNS) also show promise for seizure reduction.

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Area of Science:

  • Pediatric Neurology
  • Epilepsy Management
  • Neuroscience

Background:

  • Childhood epilepsy presents unique challenges due to the developing brain's vulnerability to seizures.
  • Established neurostimulation techniques for adults have limited data in pediatric populations.
  • There is a need to evaluate the efficacy and safety of neurostimulation in children.

Purpose of the Study:

  • To review current evidence on neurostimulation modalities for treating childhood epilepsy.
  • To assess the safety and effectiveness of Vagus Nerve Stimulation (VNS), Deep Brain Stimulation (DBS), and Responsive Neurostimulation (RNS) in pediatric patients.
  • To explore emerging non-invasive techniques like transcranial direct current stimulation (tDCS).

Main Methods:

  • Systematic review of existing literature, including retrospective and open-label studies.
  • Analysis of data from pediatric clinical trials and case studies on VNS, DBS, and RNS.
  • Evaluation of findings from small randomized controlled trials and open-label studies on tDCS.

Main Results:

  • Vagus Nerve Stimulation (VNS) demonstrates a comparable safety and efficacy profile in children to that observed in adults.
  • Deep Brain Stimulation (DBS) and Responsive Neurostimulation (RNS) show potential for reducing seizure frequency in children with minimal complications, despite limited available evidence.
  • Transcranial direct current stimulation (tDCS) has yielded promising but inconsistent results in preliminary studies for childhood epilepsy.

Conclusions:

  • Neurostimulation, particularly VNS, is a viable and effective treatment option for childhood epilepsy.
  • DBS and RNS represent promising avenues for refractory epilepsy in children, warranting further investigation.
  • Non-invasive techniques like tDCS require more robust research to establish their role in pediatric epilepsy management.