Grenoble Institut des Neurosciences, INSERM U836, Université Joseph Fourier, France.
Curr Opin Neurol. 2010 Apr;23(2):177-82. doi: 10.1097/WCO.0b013e3283374a39.
Experimental and clinical studies have suggested that epileptic seizures can be modulated or interrupted by electrical stimulations of subcortical structures that may exert a remote control on seizure generators. The aim of this review is to present these recent reports and to address the perspectives of this approach.
The use of deep brain stimulation to control several motor diseases has renewed the interest of this technique for epilepsy. Several neurology and neurosurgery groups have applied this therapy to drug-resistant forms of epilepsy for which resective surgery cannot be applied. The choice of the subcortical brain structures that are targeted strongly depends on the rationale that has been developed from experimental studies using animal models. The stimulation parameters and whether deep brain stimulation for epilepsy must be continuously applied or only when a seizure occurs are a matter of debate. This article discusses the use of stimulation of the cerebellum, caudate nucleus, anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and substantia nigra to treat epilepsy, in light of recent and less recent clinical and experimental data.
New directions for studies are proposed for a better understanding of the mechanisms of action of this treatment.
实验和临床研究表明，通过对可能对致痫灶产生远程控制的皮质下结构进行电刺激，可以调节或中断癫痫发作。本综述旨在介绍这些最新研究报告，并探讨该方法的前景。
深部脑刺激用于控制多种运动疾病，使人们对该技术治疗癫痫的兴趣重新燃起。一些神经科和神经外科小组已经将该疗法应用于无法进行切除术的耐药性癫痫形式。选择靶向的皮质下脑结构强烈取决于使用动物模型进行的实验研究中提出的基本原理。刺激参数以及深部脑刺激治疗癫痫是否必须持续应用还是仅在发作时应用，这是一个有争议的问题。本文根据最近和较不最近的临床和实验数据，讨论了小脑、尾状核、丘脑前核和中央中核、丘脑底核和黑质刺激治疗癫痫的应用。
为了更好地了解这种治疗方法的作用机制，提出了新的研究方向。
