Deep Brain Stimulation Shows Benefit in Refractory Epilepsy
Stimulation in anterior nuclei of thalamus linked to long-term reduction in seizure frequency
MONDAY, March 22 (HealthDay News) -- In adults with medically refractory partial seizures, bilateral stimulation of the anterior nuclei of the thalamus is associated with long-term reduction of seizures, according to research published online March 17 in Epilepsia.
Robert Fisher, M.D., of Stanford University in California, and colleagues analyzed data from 110 adults with partial seizures, including secondarily generalized seizures, which were inadequately controlled using anti-epileptic drugs. Patients underwent implantation of deep brain stimulation (DBS) electrodes into the anterior nuclei of the thalamus. Half of the patients received stimulation during a three-month blinded phase, then all received stimulation.
The researchers found that, in the final month of the blinded phase, the group receiving stimulation had a 29 percent greater reduction in seizures. Complex partial and self-described "most severe" seizures were both significantly decreased by stimulation. At two years, patients had a 56 percent reduction in seizure frequency. Two patients had transient acute seizures associated with stimulation, but none had symptomatic hemorrhage or brain infection, and no deaths were due to the procedure or stimulation.
"Bilateral DBS of the anterior nuclei reduces seizure frequency in medically refractory patients. Benefit of stimulation in this population usually was palliative, but 14 participants (12.7 percent) became seizure-free for at least six months. Implantation and stimulation did not directly produce enduring serious complications in this study, but this therapy is invasive and serious complications can occur," the authors write.
The study was supported by Medtronic. Several co-authors reported financial relationships with Medtronic or other companies.