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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
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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 in Childhood Epilepsy.

Soumya Ghosh1,2, Lakshmi Nagarajan3,4

  • 1Children's Neuroscience Service, Dept of Neurology, Perth Children's Hospital, Nedlands, WA, 6009, Australia. Soumya.Ghosh@health.wa.gov.au.

Indian Pediatrics
|April 7, 2025
PubMed
Summary

Neurostimulation devices offer a promising option for children with drug-resistant epilepsy, showing effectiveness and safety in reducing seizures. Further pediatric research is needed to optimize these treatments for improved seizure control and quality of life.

Keywords:
Deep brain stimulationDrug resistant epilepsyNon-invasive brain stimulationResponsive neurostimulationVagus nerve stimulation

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Area of Science:

  • Neurology
  • Pediatric Epilepsy
  • Medical Devices

Background:

  • Epilepsy affects many children, with a significant portion experiencing persistent seizures despite medication.
  • Drug-resistant epilepsy presents a major challenge in pediatric care.
  • Neurostimulation offers potential therapeutic avenues for refractory cases.

Purpose of the Study:

  • To review the evidence for various neurostimulation techniques in managing drug-resistant epilepsy in children.
  • To assess the safety and efficacy of these devices.
  • To identify gaps in current research, particularly for pediatric populations.

Main Methods:

  • Systematic review of existing literature on neurostimulation for epilepsy.
  • Inclusion of studies on vagus nerve stimulation, deep brain stimulation, responsive neurostimulation, and cortical stimulation techniques.
  • Analysis of data regarding seizure reduction, tolerability, and safety profiles.

Main Results:

  • Several neurostimulation devices demonstrate efficacy in reducing seizure burden in drug-resistant epilepsy.
  • These techniques are generally found to be safe and well-tolerated.
  • Evidence is more limited in pediatric populations, with most techniques used off-label or in trials.

Conclusions:

  • Neurostimulation is a viable option for drug-resistant epilepsy, with promising results in adults and emerging data in children.
  • Vagus nerve stimulation is the most established technique in pediatric epilepsy.
  • Further robust pediatric trials are essential to determine optimal neurostimulation strategies and parameters for improved outcomes and quality of life.