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Related Experiment Video

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Chronic Subthreshold Cortical Stimulation for Paracentral Epilepsy-A Systematic Review.

Bengi Gul Turk1, Sebastien Heyndrickx2, Kristl Vonck2

  • 1Department of Neurology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Neuromodulation : Journal of the International Neuromodulation Society
|April 11, 2026
PubMed
Summary
This summary is machine-generated.

Chronic subthreshold cortical stimulation (CSCS) offers a promising new treatment for drug-resistant epilepsy in the paracentral region, achieving high seizure freedom rates and potential neurological benefits. This novel neurostimulation approach shows superior efficacy compared to other methods for this challenging epilepsy type.

Keywords:
Chronic subthreshold cortical stimulationepileptogenic zoneneuromodulationneurostimulationparacentral epilepsy

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Area of Science:

  • Neuroscience
  • Epileptology
  • Neuromodulation

Background:

  • Drug-resistant epilepsy (DRE) in the paracentral region presents surgical challenges due to proximity to eloquent cortex.
  • Existing neurostimulation options like VNS and DBS have limited efficacy for seizure freedom.
  • Chronic subthreshold cortical stimulation (CSCS) is a novel approach targeting the epileptogenic zone.

Purpose of the Study:

  • To evaluate the efficacy and safety of CSCS in patients with paracentral DRE.
  • To assess stimulation parameters and neurologic outcomes associated with CSCS.
  • To compare CSCS outcomes with other neurostimulation modalities.

Main Methods:

  • Systematic literature review of PubMed/MEDLINE and EMBASE for studies on chronic electrical stimulation in the paracentral region.
  • Inclusion of case reports, case series, and observational studies.
  • Extraction of data on seizure outcomes, stimulation parameters, adverse events, quality of life, and neurologic effects; primary endpoints were ≥90% seizure reduction and seizure freedom.

Main Results:

  • Six studies including 17 patients with a mean follow-up of 31.3 months were analyzed.
  • Complete seizure freedom was achieved in 47% of patients, with an additional 35% experiencing ≥90% seizure reduction.
  • Lesional epilepsy cases showed significantly higher seizure freedom rates (p=0.007); no major adverse events were reported; neurologic and QOL improvements were observed.

Conclusions:

  • CSCS demonstrates promise for paracentral DRE, offering high seizure freedom rates, a favorable safety profile, and potential neuromodulatory benefits.
  • Preliminary evidence suggests CSCS may be more effective than other neurostimulation modalities for paracentral epilepsy.
  • Further prospective, controlled studies are needed to validate findings, optimize protocols, and refine patient selection.