Deep brain stimulation for intractabile epilepsy

Roberta Morace, Giancarlo Di Gennaro, Pierpaolo Quarato, Alfredo D'Aniello, Addolorata Mascia, Liliana Grammaldo, Marco De Risi, Antonio Sparano, Michelangelo De Angelis, Francesco Di Cola, Domenico Solari, Vincenzo Esposito

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Deep brain stimulation (DBS) is currently considered a promising neuromodulation therapy for refractory epilepsy not suitable for resective surgery. several anatomical targets and different stimulation approaches have been proposed in order to obtain satisfactory seizures reduction. As expected, according with different patterns of neural pathways involvement, the eficacy of each anatomical target stimulation in reducing seizure frequency varies among the different epileptic syndromes. EVIDENCE ACQUISITION: We reviewed the current literature on this topic to provide an overview of the clinical eficacy of the main stimulation targets (anterior nucleus of the thalamus [aNT], hippocampus formation [Hf] and centromedian nucleus of the thalamus [CMT]) related to the different epileptic syndromes. We also summarized the available data concerning side effects, neuropsychological outcome, quality of life and future perspective of DBs in intractable epilepsy. eViDeNce sYNTHesis: Encouraging results were reported for each target stimulation. However, only in aNT and responsive neurostimulation (RNS) the eficacy and safety were tested on large series of patients and achieving class I evidence level. Conslusions: We concluded that responsive stimulation could be more appropriate in focal epilepsy, while aNT stimulation could be properly performed also in multifocal seizures with predominant limbic involvement. Despite the small samples size, Hf stimulation reduces seizure frequency in (bi) temporal lobe epilepsy, as well as cMT stimulation is able to reduce, seizure frequency, in generalized epilepsy.

Original languageEnglish
Pages (from-to)189-198
Number of pages10
JournalJournal of Neurosurgical Sciences
Volume60
Issue number2
Publication statusPublished - 2016

Keywords

  • Deep brain stimulation
  • Drug resistant epilepsy
  • Surgical procedures, operative

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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