Document Detail


Chronic deep brain stimulation in mesial temporal lobe epilepsy.
MedLine Citation:
PMID:  21489828     Owner:  NLM     Status:  MEDLINE    
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 (130 Hz, 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 2 V) 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 (≥1 V) 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; Research Support, Non-U.S. Gov't     Date:  2011-04-12
Journal Detail:
Title:  Seizure     Volume:  20     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-13     Completed Date:  2011-10-06     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  485-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / therapeutic use
Deep Brain Stimulation* / psychology
Electrodes, Implanted
Electroencephalography
Epilepsy, Temporal Lobe / pathology,  psychology,  therapy*
Female
Follow-Up Studies
Hippocampus / pathology
Humans
Long-Term Care
Magnetic Resonance Imaging
Male
Memory / physiology
Middle Aged
Neuropsychological Tests
Neurosurgical Procedures
Sclerosis
Seizures / epidemiology,  prevention & control
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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