Torres Cristina V, Pastor Jesús, Navarrete Eduardo G, Sola Rafael G
Servicio de Neurocirugía, Hospital Universitario de la Princesa, 28006 Madrid, España.
Rev Neurol. 2011 Jul 16;53(2):99-106.
Epilepsy is a neurological disorder that affects 1-2% of the population. Despite the available treatments (drug therapy, resective surgery, vagus nerve stimulation), there is a significant subgroup of patients that continues to have disabling seizures. The indications of deep brain stimulation are exponentially growing, and there is a wide experience with deep brain stimulation (DBS) for the treatment of abnormal movements. DBS for epilepsy may be a new therapy for the subgroup of patients that remain disabled despite other treatments. Experiments with animal models, and the new advances in our knowledge about the neurophysiological processes that govern the genesis of epilepsy, have led to the selection of various brain targets for stimulation. The thalamus is a fundamental relay centre in the corticothalamic and corticostriatal thalamocortical circuits, and it has been studied with this purpose. Studies on epileptic patients have shown various degrees of effectiveness; however, controlled studies do not permit definitive conclusions about the role of DBS in the treatment of epilepsy. Probably a better patient selection would lead to more decisive conclusions. Further randomised studies are needed to draw reliable conclusions and scientific evidence on the effectiveness of DBS for refractory epilepsy.
癫痫是一种影响1%-2%人口的神经系统疾病。尽管有可用的治疗方法（药物治疗、切除性手术、迷走神经刺激），但仍有相当一部分患者持续发作致残性癫痫。脑深部电刺激的适应症正在呈指数级增长，并且在治疗异常运动方面有丰富的脑深部电刺激（DBS）经验。对于那些尽管接受了其他治疗仍致残的癫痫患者亚组，DBS可能是一种新的治疗方法。动物模型实验以及我们对控制癫痫发作起源的神经生理过程的新认识，促使人们选择了各种脑刺激靶点。丘脑是皮质丘脑和皮质纹状体丘脑皮质回路中的一个基本中继中心，并已为此进行了研究。对癫痫患者的研究显示出不同程度的疗效；然而，对照研究无法就DBS在癫痫治疗中的作用得出明确结论。可能更好的患者选择会得出更具决定性的结论。需要进一步的随机研究来得出关于DBS治疗难治性癫痫有效性的可靠结论和科学证据。
