Seizure outcome after hippocampal deep brain stimulation in a prospective cohort of patients with refractory temporal lobe epilepsy

Abstract

Although performed on a relatively small number of patients, Hip-DBS was safe and effective in our patients with r-TLE. Seven of the nine patients were considered responders. Hip-DBS might represent a useful therapeutic option in patients with refractory temporal lobe epilepsy who were not candidates for resective surgery or have had previous failed procedures.

In Search of Optimal DBS Paradigms to Treat Epilepsy: Bilateral Versus Unilateral Hippocampal Stimulation in a Rat Model for Temporal Lobe Epilepsy

“…A small randomized controlled trial in 2 patients resulted in an average reduction in seizure rate of 33% [18]. In other clinical hippocampal DBS studies, responses to bilateral hippocampal DBS varied from an increase in seizure rate in one patient [20] to a mild reduction in seizure rate of 30e49% in one patient [17]. The heterogeneity of patients and stimulation parameters in these studies, as well as the lack of a comparative unilateral hippocampal DBS period in the same patients make it impossible to compare efficacy of unilateral and bilateral hippocampal DBS in patients.…”

Epileptic activity in Alzheimer's disease: causes and clinical relevance

“…40,41,51,52 In addition to these therapies, neuromodulatory approaches, such as deep brain stimulation, transcranial magnetic stimulation, and vagus nerve stimulation, are being developed to improve cognitive function in Alzheimer’s disease and show capacity to treat seizures. 100,101 Such approaches offer the advantage of precisely targeting zones of hyperexcitability and dysfunction, but also need to consider potential adverse effects of stimulating the circuits involved. For instance, deep brain stimulation of the anterior thalamus effectively treats seizures, but carries the risk of behavioural and mood changes.…”

Deep brain stimulation for drug‐resistant epilepsy

“…Robust clinical trials demonstrate seizure frequency reductions of 40% following short-term ANT stimulation, 3 and 26%-40% following short-term HC stimulation, [34][35][36][37] in patients with primarily focal epilepsies. Pooled responder rates (seizure reduction ≥50%) were >70% for both ANT 9,18,19,[21][22][23][24][26][27][28][29][30][31][32][33] and HC-stimulated 13,14,[34][35][36][41][42][43][44][45][46][47] patients. Indeed, a recent meta-analysis found statistically significant reductions in seizure frequency secondary to ANT-DBS (high-quality evidence) and HC-DBS (moderate-quality evidence), but not for any other targets.…”