Möddel G, Coenen V A, Elger C E
Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Deutschland.
Nervenarzt. 2012 Aug;83(8):1001-5. doi: 10.1007/s00115-012-3572-z.
Neurostimulation techniques are applied to reduce the frequency and severity of epileptic seizures. Class I evidence showed that vagus nerve stimulation (VNS) reduces seizure burden by 25-28% compared to 6-15% in placebo controls. Open-label studies, however, reported much greater efficacy. Since 2010 deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) is CE approved for epilepsy therapy in Europe. A multicenter randomized controlled trial reported seizure frequency reduction by 40.4% compared to 14.5% in controls. A significant effect was only found in patients with temporal seizure onset. 13% of stimulated patients became seizure-free for at least 6 months. Possible side-effects include depression (14.8%) and memory impairment (13%). Responsive neurostimulation (RNS) combines an automated seizure detection device with on-demand triggered stimulation of the epileptogenic zone. A randomized controlled trial reported seizure frequency reduction by 37.9% compared to 17.3% in controls. There were no relevant neuropsychological or psychiatric side-effects noted.
神经刺激技术被用于降低癫痫发作的频率和严重程度。一级证据表明，与安慰剂对照组6%-15%的降低幅度相比，迷走神经刺激（VNS）可使发作负担降低25%-28%。然而，开放标签研究报告的疗效要高得多。自2010年以来，丘脑前核深部脑刺激（ANT-DBS）在欧洲已获得用于癫痫治疗的CE认证。一项多中心随机对照试验报告，与对照组14.5%的降低幅度相比，发作频率降低了40.4%。仅在颞叶发作起始的患者中发现了显著效果。13%接受刺激的患者至少6个月无癫痫发作。可能的副作用包括抑郁（14.8%）和记忆障碍（13%）。反应性神经刺激（RNS）将自动癫痫检测装置与按需触发的致痫区刺激相结合。一项随机对照试验报告，与对照组17.
