Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland, Sobieskiego 9 Street 02-957 Warsaw, Poland.
Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland, Sobieskiego 9 Street 02-957 Warsaw, Poland.
Seizure. 2020 Oct;81:58-62. doi: 10.1016/j.seizure.2020.07.022. Epub 2020 Jul 26.
Status epilepticus (SE) and super-refractory status epilepticus (SRSE) are life-threatening medical emergencies. The first-line treatment for SE or SRSE includes i. v. anesthetic agents with respiratory support, AEDs, and steroids. Surgical interventions are indicated if medical treatments fail to abrupt the seizures. Apart from resective epilepsy surgery employed for the treatment of SE and SRSE, deep brain stimulation (DBS) of thalamic nuclei is aimed at directly influencing the brain function.
The main objective of this review is to present the efficacy and safety of DBS in SE and SRSE in humans.
We performed the literature search regarding DBS therapy in the treatment of SE and SRSE. All manuscripts written in English have been analyzed and included in this review.
We were able to find 7 case reports describing DBS outcomes for the treatment of SE or SRSE in 8 patients. Six patients operated for SE or SRSE gained a significant seizure reduction or total abolition of seizures. One patient due to an infection and the other one due to a stimulation-related adverse event required the total DBS hardware removal.
Case reports suggest that DBS can be considered as one of the treatment choices in SE and SRSE cases. A small number of treated cases and various thalamic nuclei targeted by DBS electrodes preclude drawing definitive conclusions. It can be speculated that a shorter duration of refractory SE or SRSE before a DBS procedure may efficiently reduce seizure frequency.
癫痫持续状态（SE）和超难治性癫痫持续状态（SRSE）是危及生命的医学急症。SE 或 SRSE 的一线治疗包括静脉麻醉剂加呼吸支持、抗癫痫药物和类固醇。如果药物治疗未能终止发作，则需要手术干预。除了用于治疗 SE 和 SRSE 的致痫性癫痫手术外，丘脑核深部脑刺激（DBS）旨在直接影响大脑功能。
本综述的主要目的是介绍 DBS 在人类 SE 和 SRSE 中的疗效和安全性。
我们对 DBS 治疗 SE 和 SRSE 的文献进行了检索。分析并纳入了所有用英文撰写的研究报告。
我们共找到 7 篇描述 8 例患者 DBS 治疗 SE 或 SRSE 结果的病例报告。6 例因 SE 或 SRSE 接受手术的患者显著减少了癫痫发作或完全消除了癫痫发作。1 例患者因感染，另 1 例因刺激相关不良事件需要完全移除 DBS 硬件。
病例报告表明，DBS 可被视为 SE 和 SRSE 病例的治疗选择之一。由于治疗病例数量较少且 DBS 电极针对的丘脑核不同，因此无法得出明确结论。可以推测，在 DBS 治疗前 SE 或 SRSE 的持续时间较短可能会有效地降低癫痫发作频率。
