Prudently applying the therapy of anterior thalamic stimulation for refractory epilepsy: present situation and thinking / 中华神经科杂志

ABSTRACT

Recently,the U.S.Food and Drug Administration has granted premarket approval for bilateral anterior thalamic nucleus stimulation as adjunctive treatment for reducing the frequency of partial-onset seizures in adults who are refractory to three or more antiepileptic medications.The anterior nucleus of the thalamus (ANT) is a primary component of the limbic system (the Papez circuit),which represents a fundamental pathway for seizure propagation.Scholars speculated that ANT is an anatomic target that may halt or influence seizure propagation or epileptogenic foci originating within the limbic system.Some suggestions on the possible factors associated with the efficacy of ANT stimulation put forward by experts are helpful.However,given the limited clinical data,there is a lack of valid predictors of individual treatment response.Most importantly,rational patient selection relies on a detailed and careful anatomo-electro-clinical analysis for individualized treatment.