Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study
Anterior thalamic deep brain stimulation (DBS) is a palliative treatment that may be considered in patients with drug resistant epilepsy (DRE) that fail treatment with vagus nerve stimulation (VNS). Combining VNS and DBS treatment is a therapeutic approach rarely reported. This single center observa...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Epilepsy & Behavior Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986422000405 |
| _version_ | 1828090255934226432 |
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| author | Gadi Miron Ido Strauss Itzhak Fried Firas Fahoum |
| author_facet | Gadi Miron Ido Strauss Itzhak Fried Firas Fahoum |
| author_sort | Gadi Miron |
| collection | DOAJ |
| description | Anterior thalamic deep brain stimulation (DBS) is a palliative treatment that may be considered in patients with drug resistant epilepsy (DRE) that fail treatment with vagus nerve stimulation (VNS). Combining VNS and DBS treatment is a therapeutic approach rarely reported. This single center observational study aims to describe response to DBS treatment in 11 epilepsy patients resistant to medications and VNS. Patients either had inactivated VNS (DBS only) or were treated with simultaneous DBS and VNS (DBS-VNS). Focal impaired awareness (FIA) and most disabling seizure rates were examined pre-DBS implantation, 3 months following implantation, and last follow up. Overall, a decrease in FIA (47.0 ± 30.7 %, p = 0.02) and most disabling seizure rate (54.8 ± 34.2 %, p = 0.03) was seen at last follow-up (average follow-up 28.5 ± 13.5 months). Eight of 11 patients were DBS responders (most disabling seizure rate reduction above 50%). No difference in seizure control was found between seven DBS only and four DBS-VNS patients. Our results argue that patients who have failed antiseizure medication and VNS therapies, could benefit from better seizure control if treated with adjunctive DBS. Larger prospective studies are needed to assess the efficacy and safety of combined neurostimulation treatments in DRE. |
| first_indexed | 2024-04-11T05:53:58Z |
| format | Article |
| id | doaj.art-24247ea90f87487e8525be1bc941798e |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-04-11T05:53:58Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-24247ea90f87487e8525be1bc941798e2022-12-22T04:41:58ZengElsevierEpilepsy & Behavior Reports2589-98642022-01-0120100563Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational studyGadi Miron0Ido Strauss1Itzhak Fried2Firas Fahoum3Epilepsy and EEG Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Functional Neurosurgery Unit, Neurosurgery Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Functional Neurosurgery Unit, Neurosurgery Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, Israel; Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USAEpilepsy and EEG Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Corresponding author at: Epilepsy and EEG Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, Israel.Anterior thalamic deep brain stimulation (DBS) is a palliative treatment that may be considered in patients with drug resistant epilepsy (DRE) that fail treatment with vagus nerve stimulation (VNS). Combining VNS and DBS treatment is a therapeutic approach rarely reported. This single center observational study aims to describe response to DBS treatment in 11 epilepsy patients resistant to medications and VNS. Patients either had inactivated VNS (DBS only) or were treated with simultaneous DBS and VNS (DBS-VNS). Focal impaired awareness (FIA) and most disabling seizure rates were examined pre-DBS implantation, 3 months following implantation, and last follow up. Overall, a decrease in FIA (47.0 ± 30.7 %, p = 0.02) and most disabling seizure rate (54.8 ± 34.2 %, p = 0.03) was seen at last follow-up (average follow-up 28.5 ± 13.5 months). Eight of 11 patients were DBS responders (most disabling seizure rate reduction above 50%). No difference in seizure control was found between seven DBS only and four DBS-VNS patients. Our results argue that patients who have failed antiseizure medication and VNS therapies, could benefit from better seizure control if treated with adjunctive DBS. Larger prospective studies are needed to assess the efficacy and safety of combined neurostimulation treatments in DRE.http://www.sciencedirect.com/science/article/pii/S2589986422000405Drug resistant epilepsyDeep brain stimulationVagal nerve stimulationDual stimulation |
| spellingShingle | Gadi Miron Ido Strauss Itzhak Fried Firas Fahoum Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study Epilepsy & Behavior Reports Drug resistant epilepsy Deep brain stimulation Vagal nerve stimulation Dual stimulation |
| title | Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study |
| title_full | Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study |
| title_fullStr | Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study |
| title_full_unstemmed | Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study |
| title_short | Anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation: A single center observational study |
| title_sort | anterior thalamic deep brain stimulation in epilepsy patients refractory to vagus nerve stimulation a single center observational study |
| topic | Drug resistant epilepsy Deep brain stimulation Vagal nerve stimulation Dual stimulation |
| url | http://www.sciencedirect.com/science/article/pii/S2589986422000405 |
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