慢性丘脑前核刺激治疗难治性癫痫。
Chronic anterior thalamus stimulation for intractable epilepsy.
作者信息
Hodaie Mojgan, Wennberg Richard A, Dostrovsky Jonathan O, Lozano Andres M
机构信息
Division of Neurosurgery, University of Toronto, ON, Canada.
出版信息
Epilepsia. 2002 Jun;43(6):603-8. doi: 10.1046/j.1528-1157.2002.26001.x.
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.
目的
尽管接受了抗癫痫药物（AED）治疗，但仍有相当数量的癫痫患者病情控制不佳，且不符合切除性手术的条件。需要新的治疗方法来减轻这一人群的癫痫发作负担。多项观察表明，丘脑前区在癫痫发作的维持和传播中起重要作用。我们通过对难治性癫痫患者使用脑深部电刺激（DBS）来研究丘脑前区的神经调节作用。
方法
5例药物难治性癫痫患者接受了立体定向植入双侧丘脑前区DBS电极并进行刺激。
结果
治疗显示癫痫发作频率有统计学意义的显著降低，平均降低54%（平均随访15个月）。其中2例患者癫痫发作减少≥75%。在DBS电极植入或刺激后未观察到不良反应。出乎意料的是，刺激开启期和刺激关闭期的观察到的益处并无差异。
结论
丘脑前区DBS是一种安全的手术方法，对药物难治性癫痫患者可能有效。
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