Janszky József, Balás István, Kovács Norbert
Pécsi Tudományegyetem, Neurológiai Klinika, Pécs.
Ideggyogy Sz. 2011 Sep 30;64(9-10):317-20.
The deep brain stimulation (DBS) is an emerging treatment option in brain disorders in which randomized multicenter trials proved its efficacy leading to licensing different DBS methods in various brain diseases. More recently more and more brain structures have become candidates for being "target" in a possible DBS treatment of epilepsy. At present, only the DBS of the anterior nucleus of the thalamus (ANT) can be considered as a proved method for epilepsy treatment. Other potential targets for DBS treatment in epilepsy are the subthalamic nuclei, and the amygdala-hippocampus complex. There are some ongoing randomized studies to investigating their therapeutical role. The therapeutical outcome of ANT-DBS treatment in drug-resistant epilepsy seems to be better than the new antiepileptic drugs, but much worse than the results of a potential epilepsy surgery. At about 10% of patients may become seizure-free and 50% of patients may have a significant improvement. Nowadays ANT-DBS should be considered as an "ultima ratio" in those adult drug-resistant epilepsy patients with normal intelligence in which neither new antiepileptic drugs nor resective epilepsy surgery are a reasonable therapeutical options.
深部脑刺激（DBS）是脑部疾病中一种新兴的治疗选择，随机多中心试验已证明其有效性，从而使不同的DBS方法在各种脑部疾病中获得许可。最近，越来越多的脑结构成为癫痫DBS治疗中可能的“靶点”。目前，只有丘脑前核（ANT）的DBS可被视为已证实的癫痫治疗方法。癫痫DBS治疗的其他潜在靶点是丘脑底核和杏仁核-海马复合体。有一些正在进行的随机研究来调查它们的治疗作用。ANT-DBS治疗耐药性癫痫的治疗效果似乎优于新型抗癫痫药物，但远不如潜在的癫痫手术效果。约10%的患者可能无癫痫发作，50%的患者可能有显著改善。如今，对于那些智力正常的成年耐药性癫痫患者，如果新型抗癫痫药物和切除性癫痫手术都不是合理的治疗选择，ANT-DBS应被视为“最终手段”。
