Document Detail


Chronic deep brain stimulation in mesial temporal lobe epilepsy.
MedLine Citation:
PMID:  21489828     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The objective of this study was to evaluate the efficiency and the effects of changes in parameters of chronic amygdala-hippocampal deep brain stimulation (AH-DBS) in mesial temporal lobe epilepsy (TLE). Eight pharmacoresistant patients, not candidates for ablative surgery, received chronic AH-DBS (130Hz, follow-up 12-24 months): two patients with hippocampal sclerosis (HS) and six patients with non-lesional mesial TLE (NLES). The effects of stepwise increases in intensity (0-Off to 2V) and stimulation configuration (quadripolar and bipolar), on seizure frequency and neuropsychological performance were studied. The two HS patients obtained a significant decrease (65-75%) in seizure frequency with high voltage bipolar DBS (≥1V) or with quadripolar stimulation. Two out of six NLES patients became seizure-free, one of them without stimulation, suggesting a microlesional effect. Two NLES patients experienced reductions of seizure frequency (65-70%), whereas the remaining two showed no significant seizure reduction. Neuropsychological evaluations showed reversible memory impairments in two patients under strong stimulation only. AH-DBS showed long-term efficiency in most of the TLE patients. It is a valuable treatment option for patients who suffer from drug resistant epilepsy and who are not candidates for resective surgery. The effects of changes in the stimulation parameters suggest that a large zone of stimulation would be required in HS patients, while a limited zone of stimulation or even a microlesional effect could be sufficient in NLES patients, for whom the importance of the proximity of the electrode to the epileptogenic zone remains to be studied. Further studies are required to ascertain these latter observations.
Authors:
Colette Boëx; Margitta Seeck; Serge Vulliémoz; Andrea O Rossetti; Claudio Staedler; Laurent Spinelli; Alan J Pegna; Etienne Pralong; Jean-Guy Villemure; Giovanni Foletti; Claudio Pollo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-11
Journal Detail:
Title:  Seizure : the journal of the British Epilepsy Association     Volume:  -     ISSN:  1532-2688     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Dpt Neurology, University Hospital of Geneva, 1211 Geneva 14, Switzerland.
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