Daniel San-Juan1, Daniel Oswaldo Dávila-Rodríguez2, Christian Ramos Jiménez3, Manuel Sánchez González4, Sergio Mayorquín Carranza5, Jesús Ricardo Hernández Mendoza6, David J Anschel7. 1. Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. Electronic address: dirinvest@innn.edu.mx. 2. Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 3. Faculty of Medicine, Autonomous University of State of Mexico, Toluca de Lerdo, State of Mexico, Mexico. 4. Faculty of Medicine, University of Guadalajara, Guadalajara, Jalisco, Mexico. 5. Academic Unit of Medicine, Autonomous University of Nayarit, Tepic, Nayarit, Mexico. 6. Faculty of Medicine Mexicali, Autonomous University of Baja California, Dr. Humberto Torres Sangines, Mexicali, Baja California, Mexico. 7. Comprehensive Epilepsy Center of Long Island, Port Jefferson, NY, USA.
Abstract
BACKGROUND: Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are neuromodulation therapies that have been used to treat Status Epilepticus (SE). OBJECTIVE: Review the literature about the efficacy and safety of neuromodulation therapies in SE in humans. METHODS: We searched studies in PubMed, Scopus, Google Scholar and Science Direct (inception to June 2018). Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines, Oxford and GRADE scales, and Murad et al., 2018 methodological quality and synthesis of case series and case reports. RESULTS: We analyzed 27 articles (45 patients) with 4 different neuromodulation therapies. In ECT we found 80% rate of disruption of SE and 5% of adverse events was reported. Using iVNS 15/16 (93.7%) patients resolved the SE. All patients who underwent TMS and DBS aborted SE, however, 50% of patients with DBS had severe adverse events. CONCLUSIONS: Case series and case reports suggest that neuromodulation therapies can abort SE in 80-100% of patients (Oxford scale and GRADE were level 4 and D) with a wide range of adverse effects, which claims for prospective studies on the relationship be-tween efficacy and safety.
BACKGROUND: Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are neuromodulation therapies that have been used to treat Status Epilepticus (SE). OBJECTIVE: Review the literature about the efficacy and safety of neuromodulation therapies in SE in humans. METHODS: We searched studies in PubMed, Scopus, Google Scholar and Science Direct (inception to June 2018). Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines, Oxford and GRADE scales, and Murad et al., 2018 methodological quality and synthesis of case series and case reports. RESULTS: We analyzed 27 articles (45 patients) with 4 different neuromodulation therapies. In ECT we found 80% rate of disruption of SE and 5% of adverse events was reported. Using iVNS 15/16 (93.7%) patients resolved the SE. All patients who underwent TMS and DBS aborted SE, however, 50% of patients with DBS had severe adverse events. CONCLUSIONS: Case series and case reports suggest that neuromodulation therapies can abort SE in 80-100% of patients (Oxford scale and GRADE were level 4 and D) with a wide range of adverse effects, which claims for prospective studies on the relationship be-tween efficacy and safety.
Keywords:
Deep brain stimulation; Electroconvulsive therapy; Refractory status epilepticus; Status epilepticus; Transcranial magnetic stimulation; Vagal nerve stimulation
Authors: Jimmy C Yang; Nitish M Harid; Fábio A Nascimento; Vasileios Kokkinos; Abigail Shaughnessy; Alice D Lam; M Brandon Westover; Thabele M Leslie-Mazwi; Leigh R Hochberg; Eric S Rosenthal; Andrew J Cole; Robert M Richardson; Sydney S Cash Journal: Ann Clin Transl Neurol Date: 2021-05-06 Impact factor: 4.511