CHRONIC DEEP BRAIN STIMULATION IN REFRACTORY TEMPORAL LOBE EPILEPSY
Abstract number :
3.289
Submission category :
Year :
2002
Submission ID :
3432
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Kristl Vonck, Jacques Caemaert, Rik Achten, Pieter Claeys, Jacques De Reuck, Paul Boon. Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, Gent, Belgium; Neurosurgery, Ghent University Hospital, Gent, Belgium; Neuroradiology,
RATIONALE: Short-term deep brain stimulation (DBS) in medial temporal lobe structures has recently been shown to be efficacious in patients with medically refractory temporal lobe epilepsy. To date there is little information on chronic DBS in these structures. The purpose of the present study was 1. to evaluate the efficacy and safety of long-term DBS in medial temporal lobe structures and 2. to evaluate the feasability of using chronic DBS electrodes for the localisation of the ictal onset zone prior to DBS.
METHODS: In four patients with refractory complex partial seizures (CPS) and negative MRI findings four DBS electrodes were bilaterally implanted in the amygdalohippocampal region to identify and subsequently stimulate the ictal onset zone. Mean monthly CPS frequency was compared before and after chronic DBS. Side effects were carefully monitored.
RESULTS: DBS electrodes yielded high-quality EEG recordings that showed unilateral focal or regional seizure onset in medial temporal lobe structures. In all patients unilateral amygdalohippocampal stimulation was performed. After a mean follow-up of 7 months (range: 3-8 months) all patients had a [gt] 50 % reduction in seizure frequency. None of the patients reported side effects.
CONCLUSIONS: This study shows the feasibility of consecutive EEG recording and DBS in medial temporal lobe structures using DBS electrodes implanted during a single surgical procedure. Chronic DBS is an efficacious and safe treatment for refractory temporal lobe epilepsy.
[Supported by: Junior Research Grant, Fund for Scientific Research Flanders]; (Disclosure: Materials - Medtronic Europe Inc, Royalties - Medtronic Europe Inc)