Neuromodulation of epileptic foci in patients with non-lesional refractory motor epilepsy.

We report two cases of chronic therapeutic stimulation of epileptic foci localized in motor areas. Case 1 is an adolescent with supplementary motor area seizures whose intracranial recordings showed a right SMA focus. Case 2 is a female teenager with primary motor seizures originating in the right motor cortex in the hand area as shown by her intracranial recordings and cortical mapping. Both had apparently normal MRI. Chronic stimulation of the epileptic focus decreased the number of seizures more than 90% the seizure number while preserving motor function. None of the patients had side effects. Neuromodulation is proposed as a safe, efficient surgical alternative for motor seizure control.