Davis R, Emmonds S E
Kennebec Valley Medical Center, Augusta, Me.
Stereotact Funct Neurosurg. 1992;58(1-4):200-8. doi: 10.1159/000098996.
Since 1974, 32 seizure patients have undergone chronic cerebellar stimulation (CCS); 27 have been contacted with 9 (7 spastic, 2 epileptic) continuing to use CCS for an average of 14.3 years (10-17 years). 6 (67%) are seizure-free and 3 (33%) have a reduction of seizure frequency. In the last 2 years, 2 other patients with spastic seizures, who were using CCS for 13 years, died of respiratory illness; 1 had been seizure-free and the other had a reduction. Of the remaining 16 patients (12 spastic, 4 epileptic) who did use CCS for an average of 8.3 years (2-14 years) and now have nonfunctioning stimulators, 5 (31%) continue to be seizure-free, 7 (44%) have a reduction and 4 (25%) have no change or a slight increase. Overall, 23 (85%) patients have benefitted from CCS. Stimulation charge densities were 0.9-2.5 microC/cm2/phase delivered at 10-180 pulses/sec to bilateral electrode pads on the superomedial cerebellar cortex. CCS is relatively safe and nonablative, and could be offered for patients with intractable seizures originating from bilateral or extratemporal foci.
自1974年以来,32例癫痫患者接受了慢性小脑刺激(CCS)治疗;其中27例患者接受了随访,9例(7例痉挛性癫痫,2例癫痫)仍在继续使用CCS,平均使用时间为14.3年(10 - 17年)。6例(67%)患者无癫痫发作,3例(33%)癫痫发作频率降低。在过去2年中,另外2例使用CCS 13年的痉挛性癫痫患者死于呼吸系统疾病;其中1例此前无癫痫发作,另1例发作频率降低。其余16例患者(12例痉挛性癫痫,4例癫痫)平均使用CCS 8.3年(2 - 14年),目前刺激器已无功能,其中5例(31%)仍无癫痫发作,7例(44%)发作频率降低,4例(25%)无变化或略有增加。总体而言,23例(85%)患者从CCS中获益。刺激电荷密度为0.9 - 2.5微库仑/平方厘米/相位,以每秒10 - 180个脉冲的频率传递至小脑上内侧皮质的双侧电极片。CCS相对安全且非侵入性,可用于治疗起源于双侧或颞外病灶的顽固性癫痫患者。