Deep Brain Stimulation of Anterior Thalamic Nucleus for Treatment of Patient with Tuberous Sclerosis-Related Refractory Epilepsy.

BACKGROUND: Neuromodulation is recommended for patients with refractory tuberous sclerosis related epilepsy (TRE) who are unable to localize epileptogenic nodules after comprehensive preoperative evaluation or for patients and families who do not agree to resection. CASE DESCRIPTION: We report a patient with refractory TRE who received deep brain stimulation of anterior thalamic nucleus (ANT-DBS) and achieved a satisfactory response. To our knowledge, this is the first case of TRE being treated with ANT-DBS. A 22-year-old male was admitted to the hospital for refractory TRE seeking surgical treatment. Seizures were mainly manifested by deep temporal and frontal lobe epilepsy and suspected to originate in the limbic system. Magnetic resonance imaging revealed extensive potentially epileptogenic nodules in the brain lacking significant nodules. Scalp electroencephalogram showed a comprehensive, bilateral synchronous low-voltage rapid rhythm, unable to localize seizure origin. We performed bilateral ANT-DBS according to the preoperative evaluation, and the frequency and intensity of seizures were significantly reduced after the 15-month follow-up (P <0.05, Student's t-test). Our case extends the therapeutic indications of ANT-DBS to a certain extent, providing a neuromodulation alternative to vagus nerve stimulation for patients with TRE who are unsuitable candidates or refuse resection.

Clinical Observations on Superficial Surround Needling plus Quadriceps Femoris Training for the Treatment of Knee Osteoarthritis / 上海针灸杂志

ObjectiveTo investigate the efficacy of superficial surround needling plus quadriceps femoris training in treating knee osteoarthritis and observe electromyographic amplitude variations by knee osteoarthritis.MethodNinety patients diagnosed with knee osteoarthritis were randomly allocated to treatment and control groups, 45 cases each. The treatment group received superficial surround needling plus quadriceps femoris training and the control group, acupuncture alone. Both groups were treated for two weeks. Pre-treatment and post-treatment knee joint functions were scored and compared using the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale and the electromyographic integral value. Meanwhile, electromyography was performed and electromyographic amplitude variations by knee osteoarthritis were compared between the two groups of patients.ResultThe total efficacy rate was 88.9% in the treatment group and 60.0% in the control group. It was higher in the treatment group than in the control group (P<0.05). After treatment, the VAS score, the Lysholm score and the electromyographic integral value were significantly better in the treatment group than in the control group (P<0.05).ConclusionSuperficial surround needling plus quadriceps femoris training has a marked therapeutic effect on knee osteoarthritis.