Vasileios Kokkinos1,2, Alexandra Urban3,4, Nathaniel D Sisterson5, Ningfei Li6, Danielle Corson3,5, R Mark Richardson1,2. 1. Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts. 2. Harvard Medical School, Boston, Massachusetts. 3. University of Pittsburgh Comprehensive Epilepsy Center, Pittsburgh, Pennsylvania. 4. Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 5. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 6. Department for Neurology, Charité - University Medicine Berlin, Berlin, Germany.
Abstract
BACKGROUND AND IMPORTANCE: At least 25% of patients with idiopathic generalized epilepsy do not obtain adequate seizure control with medication. This report describes the first use of responsive neurostimulation (RNS), bilaterally targeting the centromedian/ventrolateral (CM/VL) region in a patient with drug-refractory Jeavons syndrome (eyelid myoclonia with absences). CLINICAL PRESENTATION: A patient, diagnosed with eyelid myoclonia with absences (EMA) and refractory to medication, was offered RNS treatment in the CM/VL region of the thalamus. Stimulation was triggered by thalamic neural activity having morphological, spectral, and synchronous features that corresponded to 3- to 5-Hz spike-wave discharges recorded on prior scalp electroencephalography. CONCLUSION: RNS decreased daily absence seizures from a mean of 60 to ≤10 and maintained the patient's level of consciousness during the occurring episodes. This therapy should be evaluated further for its potential to treat patients with pharmaco-refractory generalized epilepsy.
BACKGROUND AND IMPORTANCE: At least 25% of patients with idiopathic generalized epilepsy do not obtain adequate seizure control with medication. This report describes the first use of responsive neurostimulation (RNS), bilaterally targeting the centromedian/ventrolateral (CM/VL) region in a patient with drug-refractory Jeavons syndrome (eyelid myoclonia with absences). CLINICAL PRESENTATION: A patient, diagnosed with eyelid myoclonia with absences (EMA) and refractory to medication, was offered RNS treatment in the CM/VL region of the thalamus. Stimulation was triggered by thalamic neural activity having morphological, spectral, and synchronous features that corresponded to 3- to 5-Hz spike-wave discharges recorded on prior scalp electroencephalography. CONCLUSION: RNS decreased daily absence seizures from a mean of 60 to ≤10 and maintained the patient's level of consciousness during the occurring episodes. This therapy should be evaluated further for its potential to treat patients with pharmaco-refractory generalized epilepsy.
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
Authors: C Ákos Szabó; Melissa De La Garza; Robert Shade; Alexander M Papanastassiou; Peter Nathanielsz Journal: Epilepsy Behav Date: 2021-05-04 Impact factor: 3.337
Authors: Cameron P Beaudreault; Carrie R Muh; Alexandria Naftchi; Eris Spirollari; Ankita Das; Sima Vazquez; Vishad V Sukul; Philip J Overby; Michael E Tobias; Patricia E McGoldrick; Steven M Wolf Journal: Front Hum Neurosci Date: 2022-04-12 Impact factor: 3.473