儿童耐火性的内刺激:使用不断发展的治疗方法的单一机构经验
Rohin Singh1,2, Megan M J Bauman2, Karimul Islam3
1Department of Neurosurgery, University of Rochester, Rochester, New York, USA.
Epilepsia open
|April 1, 2025
概括
神经调节疗法,如深度大脑刺激 (DBS),响应性神经刺激 (RNS) 和慢性下值刺激 (CSS),对于儿科耐药性 (PRE) 是安全有效的. 这些治疗方法在59%的患者中显著减少了发作,为改善结果提供了希望.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
背景情况:
- 儿科耐火性 (PRE) 通常需要神经调节,当手术切除是不可行的,因为多焦点发作或雄辩的皮层参与.
- 对于PRE的神经刺激疗法的景观正在迅速发展.
研究的目的:
- 描述与各种神经刺激疗法用于PRE的机构经验.
- 评估前脑核深度大脑刺激 (DBS-ANT),中心中核深度大脑刺激 (DBS-CM),响应神经刺激 (RNS) 和慢性下值刺激 (CSS) 的安全性和有效性.
主要方法:
- 对患有PRE的儿科患者 (≤18岁) 的回顾性图表审查.
- 纳入标准:神经刺激启动后至少1年的随访.
- 响应者被定义为≥50%的发作频率减少.
主要成果:
- 包括35名患者:9名DBS-ANT,9名DBS-CM,5名RNS,12名CSS.
- 59%的患者 (23/35) 是响应者,其发作减少率为25% (DBS-ANT),89% (DBS-CM),87% (RNS) 和88% (CSS).
- 低并发症率 (9%),没有永久性缺陷;17%的人报告神经认知结果有所改善.
结论:
- 深度大脑刺激 (DBS),RNS和CSS是PRE的安全有效的神经调节选择.
- 针对个体患者量身定制治疗可以优化治疗结果.
- 神经调节为管理难以治疗的儿科提供了一个可行的替代方案.
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