MGH Epilepsy Service, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, ACC 739L, Boston, Massachusetts, 02114.
Department of Neurology, Yale Comprehensive Epilepsy Center, Yale University School of Medicine, 15 York St, LCI-7, New Haven, Connecticut, 06510.
Ann Clin Transl Neurol. 2019 Oct;6(10):2104-2109. doi: 10.1002/acn3.50858. Epub 2019 Sep 11.
Responsive neurostimulation (RNS) has emerged as an adjunctive treatment modality for patients with intractable focal epilepsy who are not surgical candidates or have more than one ictal onset focus. We report a 34-year-old patient with intractable, childhood-onset, genetic generalized epilepsy (GGE) with tonic, atonic, myoclonic and absence seizures treated with RNS. Strip electrodes over the right posterior frontal cortex and depth electrodes placed in the right anterior nucleus were used for event detection and responsive stimulation. Two-year follow-up revealed 90-95% clinical seizure reduction. This case suggests that refractory GGE may be effectively treated with RNS targeting thalamocortical networks.
反应性神经刺激（RNS）已成为一种辅助治疗手段，适用于那些无法进行手术或存在多个发作起始灶的难治性局灶性癫痫患者。我们报告了一例 34 岁难治性、儿童起病的遗传性全面性癫痫（GGE）患者，该患者出现强直-阵挛、失张力、肌阵挛和失神发作，采用 RNS 进行治疗。使用后置右额皮质的条状电极和置于右前核的深部电极进行事件检测和反应性刺激。两年的随访显示临床发作减少了 90-95%。本病例提示，针对丘脑皮质网络的 RNS 可能对难治性 GGE 有效。
