State of the art paper Deep brain stimulation for refractory epilepsy

Abstract

Deep brain stimulation (DBS) is a method of treatment utilized to control medically refractory epilepsy (RE). Patients with medically refractory epilepsy who do not achieve satisfactory control of seizures with pharmacological treatment or surgical resection of the epileptic focus and those who do not qualify for surgery could benefit from DBS. The most frequently used stereotactic targets for DBS are the anterior thalamic nucleus, subthalamic nucleus, central-medial thalamic nucleus, hippocampus, amygdala and cerebellum. The DBS is believed to be an effective method of treatment for various types of epilepsy among adults and adolescents. Side effects may be associated with implantation of electrodes and with the stimulation itself. An increasing number of publications and growing interest in DBS application for RE may result in standardization of the qualification and treatment protocol for RE with DBS.

Advanced research on deep brain stimulation in treating mental disorders (Review)

“…Physical side effects include intracranial hemorrhage, which has a prevalence of 0.4-1.3% and irreversible brain damage, which has a prevalence of 0.8% (89). Furthermore, studies in patients who have undergone DBS have found that the prevalence of infection, epileptic seizure and cutaneous complications are 0.7, 1.5 and 25%, respectively (87,90,91).…”

Microsurgical anatomy of the subthalamic nucleus: correlating fiber dissection results with 3-T magnetic resonance imaging using neuronavigation

“…21,22,33 The dorsolateral sensorimotor region of the STN in Parkinson's disease is the generally accepted target for DBS treatment of motor symptoms, such as tremor and bradykinesia. 11,13,15,28,33,42,44,56 STN stimulation has also been explored as an option to treat refractory epilepsy and obsessive-compulsive disorder. 11,13,15,28,56 Precise and thorough identification of the 3D anatomy of the STN and related structures is a prerequisite for all of these DBS procedures.…”

“…11,13,15,28,33,42,44,56 STN stimulation has also been explored as an option to treat refractory epilepsy and obsessive-compulsive disorder. 11,13,15,28,56 Precise and thorough identification of the 3D anatomy of the STN and related structures is a prerequisite for all of these DBS procedures. Safe and effective DBS procedures targeting the STN also depend on a thorough understanding of the 3D anatomy of the region, which is critical for proper assessment of both outcomes and adverse effects.…”

Neuromodulation Therapy: Nonmedical, Nonsurgical Treatment for Intractable Epilepsy

“…Other brain structures have been tried as well to control seizures; for examples, the centromedian nucleus of thalamus, the subthalamic nucleus, the substantia nigra reticulata, the caudate nucleus, the cerebellum, the posterior hypothalamus, and the caudal zona incerta [43]. Subthalamic nucleus, cerebellum, and trigeminal nerve stimulations have been considered as possible targets for intractable epilepsy especially for generalized epilepsy patients.…”