Abstract
Background: Drug-resistant epileptic patients account for 40 % of cases of epilepsy. Consequently, specific therapeutic options could be surgical resection or, if not indicated, deep brain stimulation (DBS). The aim of this study is to review data from patients affected by drug-resistant complex partial epilepsy with or without generalization treated by anterior thalamic nucleus (AN) DBS to evaluate the efficacy and potential future applications of this approach as a standard method for palliative seizure control. Methods: Six patients affected by drug-resistant complex partial seizures underwent AN DBS from March 2007 to February 2011. The preoperative tests consisted of electroencephalography (EEG), video EEG, morphologic and functional magnetic resonance imaging (MRI), non-acute positron emission tomography (PET), neuropsychological evaluation, Liverpool seizure scale, and Quality Of Life In Epilepsy (QOLIE). These tests and a seizure diary were also administered during a follow-up of at least 3 years. Results: The improvement in terms of decrease of seizures was more than 50 % in patients affected by complex partial seizures strictly related to limbic system origin. The amelioration was unsatisfactory for patients having anatomical lesions outside the limbic structures with evidence of late diffusion in limbic areas. One patient died 40 days after surgery for reasons not concerned with DBS. Conclusions: Although the limited number of enrolled patients limits the reliability of data, the results are in accordance with those found in the recent literature and deserve to be considered for further studies regarding real efficacy, indications, stimulation parameters, side effects, and complications.
| Original language | English |
|---|---|
| Pages (from-to) | 1525-1532 |
| Number of pages | 8 |
| Journal | Acta Neurochirurgica |
| Volume | 157 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Jul 8 2015 |
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Keywords
- AN DBS
- Anterior thalamic nucleus
- Deep brain stimulation
- Drug-resistant epilepsy
- Palliative seizure control
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Anterior thalamic nucleus deep brain Stimulation (DBS) for drug-resistant complex partial seizures (CPS) with or without generalization : long-term evaluation and predictive outcome. / Piacentino, Massimo; Durisotti, Christine; Garofalo, Pier Gaetano; Bonanni, Paolo; Volzone, Anna; Ranzato, Federica; Beggio, Giacomo.
In: Acta Neurochirurgica, Vol. 157, No. 9, 08.07.2015, p. 1525-1532.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Anterior thalamic nucleus deep brain Stimulation (DBS) for drug-resistant complex partial seizures (CPS) with or without generalization
T2 - long-term evaluation and predictive outcome
AU - Piacentino, Massimo
AU - Durisotti, Christine
AU - Garofalo, Pier Gaetano
AU - Bonanni, Paolo
AU - Volzone, Anna
AU - Ranzato, Federica
AU - Beggio, Giacomo
PY - 2015/7/8
Y1 - 2015/7/8
N2 - Background: Drug-resistant epileptic patients account for 40 % of cases of epilepsy. Consequently, specific therapeutic options could be surgical resection or, if not indicated, deep brain stimulation (DBS). The aim of this study is to review data from patients affected by drug-resistant complex partial epilepsy with or without generalization treated by anterior thalamic nucleus (AN) DBS to evaluate the efficacy and potential future applications of this approach as a standard method for palliative seizure control. Methods: Six patients affected by drug-resistant complex partial seizures underwent AN DBS from March 2007 to February 2011. The preoperative tests consisted of electroencephalography (EEG), video EEG, morphologic and functional magnetic resonance imaging (MRI), non-acute positron emission tomography (PET), neuropsychological evaluation, Liverpool seizure scale, and Quality Of Life In Epilepsy (QOLIE). These tests and a seizure diary were also administered during a follow-up of at least 3 years. Results: The improvement in terms of decrease of seizures was more than 50 % in patients affected by complex partial seizures strictly related to limbic system origin. The amelioration was unsatisfactory for patients having anatomical lesions outside the limbic structures with evidence of late diffusion in limbic areas. One patient died 40 days after surgery for reasons not concerned with DBS. Conclusions: Although the limited number of enrolled patients limits the reliability of data, the results are in accordance with those found in the recent literature and deserve to be considered for further studies regarding real efficacy, indications, stimulation parameters, side effects, and complications.
AB - Background: Drug-resistant epileptic patients account for 40 % of cases of epilepsy. Consequently, specific therapeutic options could be surgical resection or, if not indicated, deep brain stimulation (DBS). The aim of this study is to review data from patients affected by drug-resistant complex partial epilepsy with or without generalization treated by anterior thalamic nucleus (AN) DBS to evaluate the efficacy and potential future applications of this approach as a standard method for palliative seizure control. Methods: Six patients affected by drug-resistant complex partial seizures underwent AN DBS from March 2007 to February 2011. The preoperative tests consisted of electroencephalography (EEG), video EEG, morphologic and functional magnetic resonance imaging (MRI), non-acute positron emission tomography (PET), neuropsychological evaluation, Liverpool seizure scale, and Quality Of Life In Epilepsy (QOLIE). These tests and a seizure diary were also administered during a follow-up of at least 3 years. Results: The improvement in terms of decrease of seizures was more than 50 % in patients affected by complex partial seizures strictly related to limbic system origin. The amelioration was unsatisfactory for patients having anatomical lesions outside the limbic structures with evidence of late diffusion in limbic areas. One patient died 40 days after surgery for reasons not concerned with DBS. Conclusions: Although the limited number of enrolled patients limits the reliability of data, the results are in accordance with those found in the recent literature and deserve to be considered for further studies regarding real efficacy, indications, stimulation parameters, side effects, and complications.
KW - AN DBS
KW - Anterior thalamic nucleus
KW - Deep brain stimulation
KW - Drug-resistant epilepsy
KW - Palliative seizure control
UR - http://www.scopus.com/inward/record.url?scp=84939264913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939264913&partnerID=8YFLogxK
U2 - 10.1007/s00701-015-2498-1
DO - 10.1007/s00701-015-2498-1
M3 - Article
C2 - 26153778
AN - SCOPUS:84939264913
VL - 157
SP - 1525
EP - 1532
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
IS - 9
ER -