Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, United Kingdom.
Brain Stimul. 2012 Oct;5(4):594-8. doi: 10.1016/j.brs.2011.10.002. Epub 2011 Oct 30.
Refractory status epilepticus (RSE) is associated with high mortality. We report a potential treatment alternative.
Deep brain stimulation (DBS) of the centromedian thalamic nuclei (CMN) can be effective in the treatment of RSE.
Report of the evolution of RSE after DBS of the CMN in a 27-year-old man.
In the course of an encephalopathy of unknown origin, and after a cardiac arrest, the patient developed RSE with myoclonic jerks and generalized tonic-clonic seizures. The EEG showed continuous generalized periodic epileptiform discharges (GPEDS). Five weeks after RSE onset, bilateral DBS of the CMN was started. This treatment was immediately followed by disappearance of tonic-clonic seizures and GPEDS, suggesting a resolution of RSE. The patient continued having multifocal myoclonic jerks, probably subcortical in origin, which resolved after 4 weeks. The patient remained clinically stable for 2 months in a persistent vegetative state.
The remission of RSE, the abolition of GPEDS, and the patient survival suggest that DBS of the CMN may be efficacious in the treatment of refractory, generalized status epilepticus.
难治性癫痫持续状态（RSE）与高死亡率相关。我们报告一种潜在的治疗选择。
丘脑中央中核（CMN）深部脑刺激（DBS）可能对 RSE 的治疗有效。
报告一名 27 岁男性 CMN-DBS 治疗 RSE 的演变过程。
在不明原因的脑病过程中，患者发生了 RSE，伴有肌阵挛性抽搐和全身性强直阵挛性发作。EEG 显示持续的全身性周期性癫痫样放电（GPEDS）。在 RSE 发病 5 周后，开始双侧 CMN-DBS。该治疗立即导致强直阵挛性发作和 GPEDS 消失，提示 RSE 缓解。患者持续存在多灶性肌阵挛性抽搐，可能起源于皮质下，4 周后缓解。患者在持续植物状态下保持 2 个月的临床稳定。
RSE 的缓解、GPEDS 的消除和患者的存活表明，CMN-DBS 可能对难治性全身性癫痫持续状态的治疗有效。
