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神经刺激治疗儿童癫痫。

Neurostimulation for childhood epilepsy.

机构信息

Department of Neurology, 4Brain, Ghent University Hospital, Ghent, Belgium.

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

出版信息

Dev Med Child Neurol. 2024 Apr;66(4):440-444. doi: 10.1111/dmcn.15692. Epub 2023 Jul 14.

Abstract

The experience with neurostimulation for childhood epilepsy is far less extensive than for adults. Nevertheless, the implementation of these techniques could be of great value, especially considering the detrimental effects of ongoing seizures on the developing brain. In this review, we discuss the available evidence for neurostimulation for childhood epilepsy. Vagus nerve stimulation (VNS) is the most studied neurostimulation modality in children. Based on mostly retrospective, open-label studies, we can conclude that VNS has a similar safety and efficacy profile in children compared to adults. Although there is little available evidence for deep brain stimulation (DBS) and responsive neurostimulation (RNS) in children, both DBS and RNS show promise in reducing seizure frequency with few complications. The implementation of non-invasive techniques with a more appealing safety profile has gained interest. Small randomized control trials and open-label studies have investigated transcranial direct current simulation for childhood epilepsy, demonstrating promising but inconsistent findings.

摘要

神经刺激治疗儿童癫痫的经验远不及成人丰富。然而,这些技术的应用可能具有重要价值,尤其是考虑到持续癫痫发作对发育中大脑的有害影响。在这篇综述中,我们讨论了神经刺激治疗儿童癫痫的现有证据。迷走神经刺激(Vagus nerve stimulation,VNS)是儿童中研究最多的神经刺激方式。基于大多数回顾性、开放性研究,我们可以得出结论,VNS 在儿童中的安全性和疗效与成人相似。虽然儿童的深部脑刺激(Deep brain stimulation,DBS)和反应性神经刺激(Responsive neurostimulation,RNS)的证据很少,但 DBS 和 RNS 都显示出有希望减少癫痫发作频率,且并发症较少。具有更吸引人的安全性特征的非侵入性技术的应用引起了人们的兴趣。一些小型随机对照试验和开放性研究已经探讨了经颅直流电刺激治疗儿童癫痫,结果显示出有希望但不一致的发现。

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