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[小脑皮质电刺激对重症癫痫发作频率的影响]

[Effect of cerebellar cortical electrostimulation on the frequency of epileptic seizures in severe forms of epilepsy].

作者信息

Bidziński J, Bacia T, Ostrowski K, Czarkwiani L

出版信息

Neurol Neurochir Pol. 1981 Sep-Dec;15(5-6):605-9.

PMID:6979000
Abstract

The authors studied 14 patients with epileptic seizures occurring from one to about 20 daily despite monitored pharmacological treatment. Two pairs of silver, properly insulated electrodes were applied to the subtentorial surface of both cerebellar hemispheres through burr-holes. The cerebellar surface was stimulated once daily for 30 min to 1 hour with electrical current at 10 Hz, 1 msec, 1-7 V during 10 to 16 days. During that time epileptic seizures disappeared completely in 5 cases, in 6 patients their frequency was reduced to one seizure every several days, in 2 cases the improvement was slight and one patient failed to improve. After cessation of electrostimulation and removal of electrodes in most cases the seizures increased again in frequently gradually. Twelve months after the procedure in only 4 cases a significant improvement remained. The authors believe that this method of cerebellar cortex stimulation should be regarded as a trial before making decision about chronic implantation of cerebellar electrostimulator for selecting patients responding well to this treatment. This group amounts to about 30% of such drug-resistant cases.

摘要

作者对14例癫痫患者进行了研究,这些患者尽管接受了药物治疗监测,但每天仍会发作1次至约20次癫痫。通过钻孔将两对妥善绝缘的银电极置于两侧小脑半球的幕下表面。在10至16天的时间里,每天用10赫兹、1毫秒、1 - 7伏的电流刺激小脑表面30分钟至1小时。在此期间,5例患者的癫痫发作完全消失,6例患者的发作频率降至每几天1次,2例患者改善轻微,1例患者无改善。在大多数情况下,停止电刺激并移除电极后,癫痫发作又逐渐频繁增加。术后12个月,只有4例仍有显著改善。作者认为,在决定是否长期植入小脑电刺激器以选择对此治疗反应良好的患者之前,这种小脑皮质刺激方法应被视为一种试验。这类耐药病例中约有30%对这种治疗反应良好。

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