ABSTRACT
Neuromodulation techniques as vagus nerve stimulation (VNS) and deep brain stimulation (DBS) play important roles in treating refractory focal epilepsy. In recent years, epileptogenic zone closed-loop responsive neurostimulator system (RNS) has been gradually put into clinical practice; in 2013, it was approved by U.S. Food and Drug Administration (FDA) as an adjuvant therapy for refractory epilepsy. This article reviews the development history, clinical application, anti-epileptic mechanism and future research directions of RNS to deepen the understanding of clinical workers.
ABSTRACT
It has been suggested that epileptic seizures can be interrupted by deep brain stimulation (DBS) of various deep brain structures which may exert a therapeutic control on seizure generators or correspond to ictal onset zone themselves. Several groups have used DBS in drug-resistant epilepsy cases for which resective surgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently two randomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placed on both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity. However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteria for epilepsy DBS should be performed before long.
Subject(s)
Anterior Thalamic Nuclei , Brain , Deep Brain Stimulation , Electrodes , Epilepsy , Intralaminar Thalamic Nuclei , Light , Patient Selection , Seizures , Subthalamic Nucleus , ThalamusABSTRACT
It has been suggested that epileptic seizures can be interrupted by deep brain stimulation (DBS) of various deep brain structures which may exert a therapeutic control on seizure generators or correspond to ictal onset zone themselves. Several groups have used DBS in drug-resistant epilepsy cases for which resective surgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently two randomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placed on both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity. However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteria for epilepsy DBS should be performed before long.