Neuromodulation in Lennox-Gastaut Syndrome: Emerging therapies and future directions

Lennox-Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy with a childhood onset which is marked by multiple seizure types, cognitive impairment, and a characteristic abnormal electroencephalogram pattern. LGS is often resistant to antiseizure medications, making management of this condition challenging. Additional treatment options include a ketogenic diet or surgical intervention such as a corpus callosotomy in patients with predominant atonic seizure types. Neuromodulation therapies may also be valuable in LGS by utilizing electrical stimulation to regulate brain activity and decrease the frequency of seizures. The three main types of neuromodulation consist of responsive neurostimulation, deep brain stimulation, and vagus nerve stimulation. This focused review describes the advantages and disadvantages of the three neuromodulation techniques, important factors to consider with neuromodulation when treating patients with LGS, and future directions of these therapies.