Bercu Marian Michael, Friedman Daniel, Silverberg Alyson, Drees Cornelia, Geller Eric B, Dugan Patricia C, Devinsky Orrin, Doyle Werner H
Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, NY, United States of America; Division of Pediatric Neurosurgery, Pediatric Neurosciences Center, Helen DeVos Children's Hospital, Spectrum Health, Grand Rapids, MI, United States of America.
Comprehensive Epilepsy Center, NYU Langone Health, New York, NY, United States of America.
Epilepsy Behav. 2020 Nov;112:107389. doi: 10.1016/j.yebeh.2020.107389. Epub 2020 Sep 2.
Drug-resistant focal epilepsy (DRFE) in children can impair cognition and behavior, and lead to premature death. Increased pediatric epilepsy surgery numbers reflect the improvements in seizure control and long-term developmental outcomes. Yet, many children with DRFE are not candidates for surgical resection due to overlap of the seizure network with eloquent cortex or multiple seizure-onset zones, making surgery dangerous or ineffective. In adults, responsive neurostimulation (RNS System) therapy is safe and effective treatment for DRFE with one or two seizure foci, especially when the seizure focus is in eloquent cortex. We present six pediatric patients with DRFE who underwent RNS implantation. Our outcomes demonstrate safety, decreased clinical seizure frequency, as well as improved functional status and quality of life. Changes in the clinical seizure semiology and frequency occurred in conjunction with adjustments to the stimulation parameters, supporting the efficacy of responsive neuromodulation in children.
儿童耐药性局灶性癫痫（DRFE）会损害认知和行为，并导致过早死亡。儿科癫痫手术数量的增加反映了癫痫发作控制和长期发育结局方面的改善。然而，许多患有DRFE的儿童由于癫痫发作网络与明确的皮质或多个癫痫发作起始区重叠，不适合进行手术切除，这使得手术危险或无效。在成人中，反应性神经刺激（RNS系统）疗法对于有一两个癫痫病灶的DRFE是一种安全有效的治疗方法，尤其是当癫痫病灶位于明确的皮质时。我们介绍了6例接受RNS植入的DRFE儿科患者。我们的结果证明了安全性、临床癫痫发作频率降低，以及功能状态和生活质量的改善。临床癫痫发作症状学和频率的变化与刺激参数的调整同时发生，支持了反应性神经调节在儿童中的疗效。
