Brain stimulation for the treatment of epilepsy

Summary Direct brain stimulation is an emerging treatment of epilepsy. Scheduled or responsive stimulation has been applied. The most explored targets for scheduled stimulation are the anterior nucleus of the thalamus and the hippocampus. The anterior nucleus of the thalamus was studied in a large m...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2010-07, Vol.51 (s3), p.88-92
Main Authors: Jobst, Barbara C., Darcey, Terrance M., Thadani, Vijay M., Roberts, David W.
Format: Article
Language:English
Subjects:
Afterdischarges
Anterior nucleus of the thalamus
Anterior Thalamic Nuclei - physiopathology
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Brain Mapping
Deep brain stimulation
Deep Brain Stimulation - methods
Epilepsy - physiopathology
Epilepsy - therapy
Focal seizures
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Hippocampal stimulation
Hippocampus - physiopathology
Humans
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Pharmacology. Drug treatments
Responsive neurostimulation
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Summary:Summary Direct brain stimulation is an emerging treatment of epilepsy. Scheduled or responsive stimulation has been applied. The most explored targets for scheduled stimulation are the anterior nucleus of the thalamus and the hippocampus. The anterior nucleus of the thalamus was studied in a large multicenter trial. There was a significant seizure reduction with the stimulator “on” versus “off” during several months after stimulator implantation. The hippocampus as stimulation target has not yet been studied in a large randomized trial. Responsive stimulation applies a stimulus whenever epileptiform activity occurs. It requires on‐line detection of epileptiform activity. This concept is based on the observation that epileptiform activity during functional mapping can be aborted by brief pulses of cortical stimulation. Current technology is able to detect seizure activity intracranially on‐line and delivers a high frequency stimulus if epileptiform activity is detected. A large randomized multicenter trial has been conducted testing this system for focal epilepsy.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1167.2010.02618.x