| Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review. | |
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MedLine Citation:
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PMID: 20672925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: The wide application of deep brain stimulation in the management of movement as well as other degenerative neurological and psychiatric disorders has renewed the interest in using deep brain stimulation in the management of medically intractable epilepsy. Various stimulation targets have been used with significantly varying results in aborting seizure activity. Electrical cerebellar stimulation (CS) has been used for more than 50 years in the management of epilepsy, with conflicting results. In the current study, the authors review the pertinent literature to outline the role of CS in the management of medically refractory epilepsy. METHODS: The PubMed medical database was systematically searched for the following terms: "cerebellar," "epilepsy," "stimulation," and "treatment," and all their combinations. Case reports were excluded from this study. RESULTS: The pertinent articles were categorized into 2 large groups: animal experimental and human clinical studies. Particular emphasis on the following aspects was given when reviewing the human clinical studies: their methodological characteristics, the number of participants, their seizure types, the implantation technique and its associated complications, the exact stimulation target, the stimulation technique, the seizure outcome, and the patients' psychological and social poststimulation status. Three clinical double-blind studies were found, with similar implantation surgical technique, stimulation target, and stimulation parameters, but quite contradictory results. Two of these studies failed to demonstrate any significant seizure reduction, whereas the third one showed a significant poststimulation decrease in seizure frequency. All possible factors responsible for these differences in the findings are analyzed in the present study. CONCLUSIONS: Cerebellar stimulation seems to remain a stimulation target worth exploring for defining its potential in the treatment of medically intractable epilepsy, although the data from the double-blind clinical studies that were performed failed to establish a clear benefit in regard to seizure frequency. A large-scale, double-blind clinical study is required for accurately defining the efficacy of CS in epilepsy treatment. |
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Authors:
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Kostas N Fountas; Eftychia Kapsalaki; Georgios Hadjigeorgiou |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Neurosurgical focus Volume: 29 ISSN: 1092-0684 ISO Abbreviation: Neurosurg Focus Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-02 Completed Date: 2010-09-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896471 Medline TA: Neurosurg Focus Country: United States |
Other Details:
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Languages: eng Pagination: E8 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece. fountas@med.uth.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Anticonvulsants / therapeutic use Cats Cerebellar Cortex / physiology Cerebellum / physiology* Deep Brain Stimulation / methods Disease Models, Animal Drug Resistance Electric Stimulation Therapy / methods* Epilepsy / drug therapy, therapy* Haplorhini Humans Purkinje Cells / physiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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