Shu Wang1, Meng Zhao1, Tianfu Li2,3,4, Chunsheng Zhang1, Jian Zhou1, Mengyang Wang2, Xiongfei Wang1, Kaiqiang Ma1, Guoming Luan1,3,4, Yuguang Guan5,6,7. 1. Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, 100093, China. 2. Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing, 100093, China. 3. Beijing Key Laboratory of Epilepsy, Beijing, 100093, China. 4. Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, 100093, China. 5. Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, 100093, China. guanyuguang2013@163.com. 6. Beijing Key Laboratory of Epilepsy, Beijing, 100093, China. guanyuguang2013@163.com. 7. Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, 100093, China. guanyuguang2013@163.com.
Abstract
PURPOSE: Temporal lobe epilepsy patients treated with hippocampal deep brain stimulation (Hip-DBS) have rarely been reported before. Preoperative and postoperative cognitive function is seldom analyzed. METHODS: Seven patients with drug-resistant temporal lobe epilepsy were included in this study. Bilateral Hip-DBS was performed in these patients. The stimulator was activated 1 month after the implantation. Then, the patients returned for further adjustments 4 months after the surgery and reprogramming every year. The seizure frequency, Wechsler Adult Intelligence Scale-IV, and Wechsler memory scale-IV were assessed blindly as the outcomes at each follow-up. RESULTS: After a mean 48-month follow-up, the mean seizure frequency significantly decreased (p = 0.011, paired t test; decrease of 78.1%). One patient (14.3%) was seizure-free by the last follow-up; six of seven (85.7%) patients had reductions in seizure frequency of at least 50%; one patient (14.3%) who did not comply with the antiepileptic drug instructions had a less than 50% reduction in seizure frequency. In addition, there were no significant decreases in intelligence or verbal and visual memory from baseline to the last follow-up (p = 0.736, paired t test; p = 0.380, paired t test, respectively). CONCLUSION: Hip-DBS could provide acceptable long-term efficacy and safety. For patients with drug-resistant temporal lobe epilepsy who are not suitable for resective surgery, Hip-DBS could become a potential therapeutic option.
PURPOSE:Temporal lobe epilepsypatients treated with hippocampal deep brain stimulation (Hip-DBS) have rarely been reported before. Preoperative and postoperative cognitive function is seldom analyzed. METHODS: Seven patients with drug-resistant temporal lobe epilepsy were included in this study. Bilateral Hip-DBS was performed in these patients. The stimulator was activated 1 month after the implantation. Then, the patients returned for further adjustments 4 months after the surgery and reprogramming every year. The seizure frequency, Wechsler Adult Intelligence Scale-IV, and Wechsler memory scale-IV were assessed blindly as the outcomes at each follow-up. RESULTS: After a mean 48-month follow-up, the mean seizure frequency significantly decreased (p = 0.011, paired t test; decrease of 78.1%). One patient (14.3%) was seizure-free by the last follow-up; six of seven (85.7%) patients had reductions in seizure frequency of at least 50%; one patient (14.3%) who did not comply with the antiepileptic drug instructions had a less than 50% reduction in seizure frequency. In addition, there were no significant decreases in intelligence or verbal and visual memory from baseline to the last follow-up (p = 0.736, paired t test; p = 0.380, paired t test, respectively). CONCLUSION: Hip-DBS could provide acceptable long-term efficacy and safety. For patients with drug-resistant temporal lobe epilepsy who are not suitable for resective surgery, Hip-DBS could become a potential therapeutic option.
Entities:
Keywords:
Cognitive function; Deep brain stimulation; Epilepsy; Hippocampal; Temporal lobe
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