Deep Brain Stimulation for Refractory Temporal Lobe Epilepsy. Current Status and Future Trends.

A comparative analysis of the targets for deep brain stimulation (DBS) to treat refractory temporal lobe epilepsy and the rationale for its use is presented, with an emphasis on the latency to obtain the significant antiepileptic effect and the long-term seizure control. The analysis includes consideration of surgical techniques currently used to optimize antiseizure effects and decrease surgical risks. Seizure control is similar for programed DBS and DBS responsive to abnormal cortical or subcortical electroencephalogram (EEG) activity. There is no difference in the long-term seizure control between programmed and responsive and intermittent or continuous DBS. However, intermittent programed DBS may have a significant antiseizure effect starting in the first month when applied to a non-sclerotic tissue such as the parahippocampal cortex. DBS induces no neuropsychological deterioration.

[Intracranial electrode recording prognostic value in anterior temporal lobectomy and hypocampectomy]. / Valor pronóstico de los registros intracraneales en la lobectomía temporal anterior con hipocampectomía.

UNLABELLED: The experience obtained in the Epilepsy Clinic of the General Hospital of México in regard to the use of intracraneal electrodes to determine the epileptic tissue that must be resected in an anterior temporal lobectomy with amygdalo-hippocampectomy in patients with intractable mesial temporal lobe seizures is described. The data obtained while recording the electroencephalographic activity with these electrodes to learn about its impact in the postsurgical result (seizure reduction and complications) both in the first year and long-term (up to 17 years) follow-up was analyzed. Fifty seven patients implanted between years 1993-2008 were included. Forty eight patients (84%) were seizure and medication free in the first year of postsurgical follow-up. Five patients relapsed after five years of being seizure free. There were no serious complications caused by the use of intracraneal electrodes per se and neurological deficits were barely noticeable in one patient due to the lobectomy. CONCLUSION: the use of intracraneal electrodes is a safe and effective diagnostic method that contributes to the good postsurgical long-term outcome in those patients previously excluded for a possible surgery.