Anterior Thalamic Stimulation Induced Relapsing Encephalitis

Hamdi, Hussein; Robin, Elsa E.; Stahl, Jean-Paul; Doche, Emilie; Chabardes, Stephan; Bartolomei, Fabricē; Régis, Jean

doi:10.1159/000499072

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…There is evidence that deep brain stimulation of the anterior and centromedian nuclei of the thalamus, subthalamic nucleus, striatum, globus pallidus and cerebellum are effective in controlling seizures [158][159][160][161]. There is one study in which stimulation of the anterior thalamic nucleus inhibited SE in experimental pilocarpine rat models [161], but the use of deep brain stimulation in the treatment of SRSE in humans is underwhelming.…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Kirmani¹,

Au²,

Ayari³

et al. 2021

Aging and disease

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Super-refractory status epilepticus (SRSE) is a life-threatening neurological emergency with high morbidity and mortality. It is defined as "status epilepticus (SE) that continues or recurs 24 hours or more after the onset of anesthesia, including those cases in which SE recurs on the reduction or withdrawal of anesthesia." This condition is resistant to normal protocols used in the treatment of status epilepticus and exposes patients to increased risks of neuronal death, neuronal injury, and disruption of neuronal networks if not treated in a timely manner. It is mainly seen in patients with severe acute onset brain injury or presentation of new-onset refractory status epilepticus (NORSE). The mortality, neurological deficits, and functional impairments are significant depending on the duration of status epilepticus and the resultant brain damage. Research is underway to find the cure for this devastating neurological condition. In this review, we will discuss the wide range of therapies used in the management of SRSE, provide suggestions regarding its treatment, and comment on future directions. The therapies evaluated include traditional and alternative anesthetic agents with antiepileptic agents. The other emerging therapies include hypothermia, steroids, immunosuppressive agents, electrical and magnetic stimulation therapies, emergent respective epilepsy surgery, the ketogenic diet, pyridoxine infusion, cerebrospinal fluid drainage, and magnesium infusion. To date, there is a lack of robust published data regarding the safety and effectiveness of various therapies, and there continues to be a need for large randomized multicenter trials comparing newer therapies to treat this refractory condition.

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Section: Deep Brain Stimulationmentioning

confidence: 99%

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Kirmani¹,

Au²,

Ayari³

et al. 2021

Aging and disease

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“…ANT-DBS is generally safe and well tolerated, but several adverse events are associated with it, either hardware-related or operation-related complications, which mostly occur around the time of device implantation 3 . While the stimulation-related adverse effect is usually mild and adjustable, a recent report presented a unique case of herpes simplex encephalitis reactivation 1 month after ANT-DBS implantation among patients with DRE, providing evidence for a role of ANT-DBS in the modulation of the inflammatory response 7 .…”

Section: Introductionmentioning

confidence: 99%

A 1-year follow-up study on immunological changes following deep brain stimulation in patients with epilepsy

Basnyat

Järvenpää

Raitanen

et al. 2021

Sci Rep

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The aim of this study was to evaluate the effects of deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) on systemic inflammatory responses in patients with drug-resistant epilepsy (DRE). Twenty-two Finnish patients with ANT-DBS implantation were enrolled in this pilot study. Changes in plasma interleukin-6 (IL-6) and interleukin-10 (IL-10) levels were examined using generalized estimating equation models at seven time points (before DBS surgery and 1, 2, 3, 6, 9 and 12 months after implantation). In the whole group, the IL-6/IL-10 ratio decreased significantly over time following ANT-DBS, while the decrease in IL-6 levels and increase in IL-10 levels were not significant. In the responder and nonresponder groups, IL-6 levels remained unchanged during the follow-up. Responders had significantly lower pre-DBS IL-10 levels before the ANT-DBS treatment than nonresponders, but the levels significantly increased over time after the treatment. In addition, responders had a higher pre-DBS IL-6/IL-10 ratio than nonresponders, and the ratio decreased for both groups after treatment, but the decrease did not reach the level of statistical significance. The rate of decrease in the ratio per month tended to be higher in responders than in nonresponders. These results may highlight the anti-inflammatory properties of ANT-DBS treatment associated with its therapeutic effectiveness in patients with DRE. Additional studies are essential to evaluate the potential of the proinflammatory cytokine IL-6, the anti-inflammatory cytokine IL-10, and their ratio as biomarkers to evaluate the therapeutic response to DBS treatment, which could facilitate treatment optimization.

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“…It is believed that virologic relapse in HSE is a consequence of reactivation of a latent HSV in the trigeminal or olfactory root ganglia whereas first HSE episodes follow viral ascent from oral sites via the trigeminal or olfactory nerves in HSV-1 and from genital sites via sacral nerve roots in HSV-2 [5]. It has been observed that reactivation of latent HSV infection leading to virologic relapse of HSE may follow immunosuppression [13], chemoradiation [14], and deep brain stimulation among others [15].…”

Section: Introductionmentioning

confidence: 99%

Relapse of herpes simplex encephalitis in a patient with metastatic small cell lung cancer following scalp sparing whole brain radiotherapy

Balkhair

Wahaibi

Raniga

et al. 2019

IDCases

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HighlightsLate virologic relapse of Herpes simplex virus encephalitis [HSE] is a scarcely reported clinical entity.We report a case of HSE with late virologic relapse in a patient with metastatic small cell lung cancer.Possible association between cranial radiotherapy and dexamethasone with subsequent risk of HSE and relapse is exemplified.We propose antiviral prophylaxis for at-risk immunocompromised patients receiving dexamethasone or whole brain radiotherapy.We emphasised the seriousness of virologic relapse of HSE in immunocompromised patients.

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Anterior Thalamic Stimulation Induced Relapsing Encephalitis

Cited by 6 publications

References 16 publications

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

A 1-year follow-up study on immunological changes following deep brain stimulation in patients with epilepsy

Relapse of herpes simplex encephalitis in a patient with metastatic small cell lung cancer following scalp sparing whole brain radiotherapy

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