Torres C V, Pastor J, Navarrete E G, Sola R G
Servicio de Neurocirugía, Hospital Universitario de la Princesa, Madrid, España.
Rev Neurol. 2011 Aug 1;53(3):153-64.
Epilepsy is a neurological disorder that affects 1-2% of the population. The majority of epileptic patients achieve a good seizure control with the current available treatments. However, there is a subgroup of patients that remain severely disable despite the variety of anti-epileptic drugs, the possibility of surgery for resection of the epileptogenic foci in selected patients, and vagal nerve stimulation; various lines of research are being carried out to look for new treatment alternatives. Deep brain stimulation (DBS) of the thalamus has emerged as a therapeutic alternative for patients who remain in-capacitated; the efficacy of this new therapy is subject of several studies, and its effectiveness and safety has not been established yet. There are other targets for deep brain stimulation that may be useful for drug-resistant epilepsy. Experiments with animal models and preliminary human studies have shown encouraging results with DBS on cerebellum, subthalamic nucleus, substantia nigra, hippocampus and cerebral cortex, among others. The purpose of this review is to revisit the studies that have been carried out on these brain nuclei, as targets for DBS for drug-resistant epilepsy. Studies have shown varying degrees of effectiveness, and there is a need for controlled trials to draw any definite conclusions.
癫痫是一种影响1%至2%人口的神经系统疾病。大多数癫痫患者通过现有的治疗方法能实现良好的癫痫发作控制。然而，有一小部分患者尽管使用了多种抗癫痫药物、部分患者有可能通过手术切除致痫灶以及采用迷走神经刺激疗法，但仍严重致残；目前正在开展各种研究以寻找新的治疗方案。丘脑深部脑刺激（DBS）已成为对仍无行为能力患者的一种治疗选择；这种新疗法的疗效是多项研究的主题，其有效性和安全性尚未确立。还有其他一些深部脑刺激靶点可能对耐药性癫痫有用。动物模型实验和初步人体研究表明，对小脑、丘脑底核、黑质、海马体和大脑皮层等进行DBS已取得了令人鼓舞的结果。本综述的目的是回顾针对这些脑核作为耐药性癫痫DBS靶点所开展的研究。研究显示了不同程度的有效性，需要进行对照试验才能得出任何明确结论。
