Issa Roach Alexandra T, Chaitanya Ganne, Riley Kristen O, Muhlhofer Wolfgang, Pati Sandipan
Department of Neurology, University of Alabama at Birmingham, AL, United States of America.
Department of Neurosurgery, University of Alabama at Birmingham, AL, United States of America.
Epilepsy Behav. 2020 Jan;102:106814. doi: 10.1016/j.yebeh.2019.106814. Epub 2019 Dec 2.
There is an unmet need to improve therapy for neuropsychiatric comorbidities that are highly prevalent in persons with epilepsy (PWE). However, diagnosing and monitoring the neurobehavioral symptoms is challenging as their presentation can overlap with seizures. In this retrospective study, we report the advantage of chronic ambulatory electrocorticography (ECoG) from implanted Responsive Neurostimulator System (RNS®) in characterizing these psychosomatic paroxysms as a possible ictal, postictal, or interictal phenomenon and how the diagnosis guided the therapy choices. Five out of 21 patients with RNS had neuropsychiatric symptoms (panic attack, psychosis, conversion, and somatization disorders) that overlapped with their seizure semiology and were found to benefit from the use of RNS ECoG data by timely diagnosing and titrating targeted therapies. The cases illustrate the use of RNS ECoG data in diagnosing and improving the management of comorbidities in PWE. The ability to access RNS ECoG data and correlate it with patient symptoms is unique among available therapeutic options for PWE.
改善癫痫患者（PWE）中高度流行的神经精神共病的治疗方法仍未得到满足。然而，诊断和监测神经行为症状具有挑战性，因为它们的表现可能与癫痫发作重叠。在这项回顾性研究中，我们报告了植入式响应神经刺激系统（RNS®）的慢性动态皮层脑电图（ECoG）在将这些心身性发作特征化为可能的发作期、发作后期或发作间期现象方面的优势，以及诊断如何指导治疗选择。21例植入RNS的患者中有5例出现了与癫痫发作症状学重叠的神经精神症状（惊恐发作、精神病、转换障碍和躯体化障碍），通过及时诊断和调整靶向治疗，发现他们受益于RNS ECoG数据的使用。这些病例说明了RNS ECoG数据在诊断和改善PWE共病管理中的应用。在PWE现有的治疗选择中，能够获取RNS ECoG数据并将其与患者症状相关联是独一无二的。
