Hartshorn Alendia, Jobst Barbara
Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-1000, USA.
Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Ther Adv Chronic Dis. 2018 Jul;9(7):135-142. doi: 10.1177/2040622318774173. Epub 2018 May 7.
Stimulation devices are considered in patients with drug-resistant epilepsy and who are not surgical candidates. Responsive neurostimulation (RNS) is a cortically based stimulator activated by electrocorticography (ECoG) patterns. Stimulation is applied directly to the seizure focus. The vagal nerve stimulator AspireSR 106 is also a responsive device which, in addition to basal stimulation, is activated by tachycardia. Deep brain stimulation of the anterior nucleus of the thalamus is used in Europe for intractable epilepsy and yields similar response rates to RNS using duty cycle stimulation. Chronic subthreshold cortical stimulation is an experimental form of constant, low-level stimulation applied to a seizure focus. These modalities are discussed and compared in this review.
对于耐药性癫痫患者且不适合手术的患者，会考虑使用刺激装置。响应性神经刺激（RNS）是一种基于皮层的刺激器，由皮层脑电图（ECoG）模式激活。刺激直接应用于癫痫发作灶。迷走神经刺激器AspireSR 106也是一种响应性装置，除了基础刺激外，还可由心动过速激活。在欧洲，丘脑前核的深部脑刺激用于治疗难治性癫痫，其使用占空比刺激时的反应率与RNS相似。慢性阈下皮层刺激是一种应用于癫痫发作灶的持续、低水平刺激的实验形式。本文将对这些方式进行讨论和比较。
