Seizure outcome after hippocampal deep brain stimulation in patients with refractory temporal lobe epilepsy: A prospective, controlled, randomized, double‐blind study

Cukiert, Arthur; Cukiert, Cristine Mella; Burattini, José Augusto; Mariani, Pedro Paulo; Bezerra, Daniela Fontes

doi:10.1111/epi.13860

Cited by 90 publications

(91 citation statements)

References 18 publications

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“…Thus, according to a randomized study, assessing the effectiveness of hippocampal stimulation in patients with temporal lobe DRE, a positive effect in the form of complete disappearance of seizures was found in 50% of patients. (27) Other studies have shown that after 11 years of deep brain stimulation, the attacks were not registered for at least 12 months in only 13.8% of the patients. (28) The principle of this method lies in electrode implantation into certain brain structures (target-structures); these electrodes are supplied with low voltage and high frequency electric current.…”

Section: Deep Brain Stimulationmentioning

confidence: 94%

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

Narodova¹,

Shnayder²,

Narodova³

et al. 2018

IJBM

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This review is dedicated to the issue of non-pharmacological treatment of epilepsy in the adult population in Russia and other countries. A literature review was conducted using international databases for the period between 2010 and 2017. A total of 64 full-text editions were included in this review, which allowed us to reveal the basic non-pharmacological epilepsy treatment options. However, not all of these options have a sufficient evidence base, and some of them are not always safe. Particularly, methods with a low level of evidence include acupuncture and aromatherapy. Further studies are needed to explore the methods aimed at eliminating the dominant epileptic system through the development of a new, more powerful dominant system. One of the methods that can influence the pathogenesis of epilepsy is physical activity for patients with epilepsy, since epileptiform activity is reported to disappear from the EEG during exercises. The positive results of the application of music therapy are also described in the modern literature. Specifically, according to the results of some studies, the positive effect of reducing the frequency of seizures was achieved in epileptic patients who listened to music during sleep over a year. However, these studies are not numerous, so they cannot constitute a high level of evidence. Therefore, care should be exercised in applying these methods in epileptic patients. (International Journal of Biomedicine. 2018;8(1):9-14.)

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Section: Deep Brain Stimulationmentioning

confidence: 94%

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

Narodova¹,

Shnayder²,

Narodova³

et al. 2018

IJBM

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“…The majority of patients (n = 27) had generalized or secondarily generalized seizures ( Table 2). Four patients had previous episodes of status epilepticus, 7,24,45 including 1 patient who was in a continu-ous 4-week episode of intractable status epilepticus, which only improved after DBS treatment. 24 Five patients had previous surgery in an attempt to treat their epilepsy.…”

Section: Seizure Characteristicsmentioning

confidence: 99%

A systematic review of deep brain stimulation for the treatment of drug-resistant epilepsy in childhood

Yan

Toyota

Anderson

et al. 2019

Journal of Neurosurgery: Pediatrics

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OBJECTIVEDrug-resistant epilepsy (DRE) presents a therapeutic challenge in children, necessitating the consideration of multiple treatment options. Although deep brain stimulation (DBS) has been studied in adults with DRE, little evidence is available to guide clinicians regarding the application of this potentially valuable tool in children. Here, the authors present the first systematic review aimed at understanding the safety and efficacy of DBS for DRE in pediatric populations, emphasizing patient selection, device placement and programming, and seizure outcomes.METHODSThe systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendations. Relevant articles were identified from 3 electronic databases (MEDLINE, Embase, and Cochrane CENTRAL) from their inception to November 17, 2017. Inclusion criteria of individual studies were 1) diagnosis of DRE; 2) treatment with DBS; 3) inclusion of at least 1 pediatric patient (age ≤ 18 years); and 4) patient-specific data. Exclusion criteria for the systematic review included 1) missing data for age, DBS target, or seizure freedom; 2) nonhuman subjects; and 3) editorials, abstracts, review articles, and dissertations.RESULTSThis review identified 21 studies and 40 unique pediatric patients (ages 4–18 years) who received DBS treatment for epilepsy. There were 18 patients with electrodes placed in the bilateral or unilateral centromedian nucleus of the thalamus (CM) electrodes, 8 patients with bilateral anterior thalamic nucleus (ATN) electrodes, 5 patients with bilateral and unilateral hippocampal electrodes, 3 patients with bilateral subthalamic nucleus (STN) and 1 patient with unilateral STN electrodes, 2 patients with bilateral posteromedial hypothalamus electrodes, 2 patients with unilateral mammillothalamic tract electrodes, and 1 patient with caudal zona incerta electrode placement. Overall, 5 of the 40 (12.5%) patients had an International League Against Epilepsy class I (i.e., seizure-free) outcome, and 34 of the 40 (85%) patients had seizure reduction with DBS stimulation.CONCLUSIONSDBS is an alternative or adjuvant treatment for children with DRE. Prospective registries and future clinical trials are needed to identify the optimal DBS target, although favorable outcomes are reported with both CM and ATN in children.

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“…DBS has also been considered in children who have already undergone resective surgery without significant post-operative seizure reduction [14,24,25]. DBS has been used in four children who had a history of status epilepticus with an improvement in seizure frequency in three of these children [15,26].…”

Section: Predictors Of Responsementioning

confidence: 99%

Invasive Neuromodulation for the Treatment of Pediatric Epilepsy

2019

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Neuromodulatory strategies are increasingly adopted for the treatment of intractable epilepsy in children. These encompass a wide range of treatments aimed at externally stimulating neural circuitry in order to decrease seizure frequency. In the current review, the authors discuss the evidence for invasive neuromodulation, namely vagus nerve and deep brain stimulation in affected children. Putative mechanisms of action and biomarkers of treatment success are explored and evidence of the efficacy of invasive neuromodulation is highlighted.

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Seizure outcome after hippocampal deep brain stimulation in patients with refractory temporal lobe epilepsy: A prospective, controlled, randomized, double‐blind study

Cited by 90 publications

References 18 publications

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

A systematic review of deep brain stimulation for the treatment of drug-resistant epilepsy in childhood

Invasive Neuromodulation for the Treatment of Pediatric Epilepsy

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