Chronic deep brain stimulation of subthalamic and anterior thalamic nuclei for controlling refractory partial epilepsy

Abstract

Objectives: Experimental data and case reports of intractable epilepsy patients treated with deep brain stimulation (DBS) of the internal nuclei suggest a considerable anticonvulsant effect. We intended to describe the results of DBS on subthalamic nuclei and anterior thalamic nuclei (STN and ATN) from our patients and to evaluate the long-term efficiency and safety of DBS for controlling intractable epilepsy.

Methods: Six patients with refractory epilepsy and inadequate for surgery were implanted with DBS electrodes (3 in STN and 3 in ATN, respectively), switched on after a week of insertion followed by chronological observation. Seizure counts were monitored and compared with pre-implantation baseline.

Results: There was significant clinical improvement in respect of reduction of seizure frequency as well as the alleviation of ictal severity in almost patients. The mean reduction in seizure frequency was 62.3% (49.1% from STN vs. 75.4% from ATN). Except one patient (patient 3) with accidental infection on the right anterior chest, no complication or withdrawal of DBS was seen during our study.

Conclusion: DBS on STN and ATN demonstrated their clear efficiency and relative safety comparable or superior to previous studies during long term follow-up. Subsequent, well designed studies warrant the further increase of the knowledge about antiepileptic effect of DBS.