Lee Kyung Jin, Shon Young Min, Cho Chul Bum
Department of Neurosurgery, College of Medicine, Yeouido Saint Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
Stereotact Funct Neurosurg. 2012;90(6):379-85. doi: 10.1159/000339991. Epub 2012 Aug 23.
Many patients with epilepsy have persistent seizures despite treatment with maximal antiepileptic drug therapy and are not candidates for resective brain surgery.
We investigated the effectiveness of seizure reduction after anterior thalamic nucleus (ATN) stimulation in patients with intractable epilepsy undergoing deep brain stimulation (DBS) of the thalamus.
Patients included in this study had poorly controlled seizures, despite anticonvulsant medication, and were not candidates for surgical resection of an identifiable seizure focus. Fifteen patients with medically refractory epilepsy underwent the placement of bilateral DBS electrodes in the anterior thalamus. The seizure frequency was monitored and compared with the preimplantation baseline.
The treatment demonstrated a statistically significant decrease in the seizure frequency, with a mean reduction of 70.4% (mean follow-up, 27 months). Two of the patients had a remarkable reduction of seizure frequency.
It seems to be important that the short-term outcome of ATN DBS reflects the long-term outcome directly. The correlation between the seizure type, characteristics and anticonvulsant effects of ATN DBS did not exhibit significance because of the small number of cases. Therefore, a longer-term follow-up with a larger group of patients is required to fully evaluate the safety and effectiveness of this treatment modality.
许多癫痫患者尽管接受了最大剂量的抗癫痫药物治疗，仍有持续性发作，且不适合进行切除性脑手术。
我们研究了丘脑前核（ATN）刺激对接受丘脑深部脑刺激（DBS）的难治性癫痫患者减少发作的有效性。
本研究纳入的患者尽管使用了抗惊厥药物，但癫痫发作控制不佳，且不适合对可识别的癫痫病灶进行手术切除。15例药物难治性癫痫患者在丘脑前部植入了双侧DBS电极。监测癫痫发作频率并与植入前基线进行比较。
治疗显示癫痫发作频率有统计学意义的降低，平均降低70.4%（平均随访27个月）。其中2例患者癫痫发作频率显著降低。
ATN DBS的短期结果直接反映长期结果似乎很重要。由于病例数较少，ATN DBS的癫痫发作类型、特征与抗惊厥效果之间的相关性未显示出显著性。因此，需要对更多患者进行更长时间的随访，以全面评估这种治疗方式的安全性和有效性。
