PURPOSE: A significant number of patients with epilepsy remain poorly controlled despite antiepileptic medication (AED) treatment and are not eligible for resective surgery. Novel therapeutic methods are required to decrease seizure burden in this population. Several observations have indicated that the anterior thalamic region plays an important role in the maintenance and propagation of seizures. We investigated neuromodulation of the anterior thalamus by using deep-brain stimulation (DBS) in patients with intractable seizures. METHODS: Five patients with medically refractory epilepsy underwent stereotactic placement of and received stimulation through bilateral DBS electrodes in the anterior thalamus. RESULTS: Treatment showed a statistically significant decrease in seizure frequency, with a mean reduction of 54% (mean follow-up, 15 months). Two of the patients had a seizure reduction of > or =75%. No adverse effects were observed after DBS electrode insertion or stimulation. Unexpectedly, the observed benefits did not differ between stimulation-on and stimulation-off periods. CONCLUSIONS: DBS of the anterior thalamus is a safe procedure and possibly effective in patients with medically resistant seizures.
PURPOSE: A significant number of patients with epilepsy remain poorly controlled despite antiepileptic medication (AED) treatment and are not eligible for resective surgery. Novel therapeutic methods are required to decrease seizure burden in this population. Several observations have indicated that the anterior thalamic region plays an important role in the maintenance and propagation of seizures. We investigated neuromodulation of the anterior thalamus by using deep-brain stimulation (DBS) in patients with intractable seizures. METHODS: Five patients with medically refractory epilepsy underwent stereotactic placement of and received stimulation through bilateral DBS electrodes in the anterior thalamus. RESULTS: Treatment showed a statistically significant decrease in seizure frequency, with a mean reduction of 54% (mean follow-up, 15 months). Two of the patients had a seizure reduction of > or =75%. No adverse effects were observed after DBS electrode insertion or stimulation. Unexpectedly, the observed benefits did not differ between stimulation-on and stimulation-off periods. CONCLUSIONS: DBS of the anterior thalamus is a safe procedure and possibly effective in patients with medically resistant seizures.
Authors: Vivianne L Tawfik; Su-Youne Chang; Frederick L Hitti; David W Roberts; James C Leiter; Svetlana Jovanovic; Kendall H Lee Journal: Neurosurgery Date: 2010-08 Impact factor: 4.654
Authors: Vicenta Salanova; Thomas Witt; Robert Worth; Thomas R Henry; Robert E Gross; Jules M Nazzaro; Douglas Labar; Michael R Sperling; Ashwini Sharan; Evan Sandok; Adrian Handforth; John M Stern; Steve Chung; Jaimie M Henderson; Jacqueline French; Gordon Baltuch; William E Rosenfeld; Paul Garcia; Nicholas M Barbaro; Nathan B Fountain; W Jeffrey Elias; Robert R Goodman; John R Pollard; Alexander I Tröster; Christopher P Irwin; Kristin Lambrecht; Nina Graves; Robert Fisher Journal: Neurology Date: 2015-02-06 Impact factor: 9.910