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Review
. 2016 Aug 22;8(8):e744.
doi: 10.7759/cureus.744.

Post-Traumatic, Drug-Resistant Epilepsy and Review of Seizure Control Outcomes from Blinded, Randomized Controlled Trials of Brain Stimulation Treatments for Drug-Resistant Epilepsy

Michael Larkin  1 , R Michael Meyer  1 , Nicholas S Szuflita  1 , Meryl A Severson  2 , Zachary T Levine  3
Affiliations
Review

Post-Traumatic, Drug-Resistant Epilepsy and Review of Seizure Control Outcomes from Blinded, Randomized Controlled Trials of Brain Stimulation Treatments for Drug-Resistant Epilepsy

Michael Larkin et al. Cureus. .

Abstract

Background: Many post-traumatic epilepsy (PTE) patients become resistant to medications. Nervous stimulation as a treatment for drug-resistant epilepsy (DRE) is an active area of clinical investigation.

Objective: To summarize methods, reported seizure control outcome measures, and adverse events from blinded, randomized control trials (RCTs) for selected invasive brain stimulation (IBS) and non-invasive brain stimulation (NIBS) treatment options in patients with DRE.

Methods: PubMed was searched for articles from 1995-2014, using search terms related to the topics of interest. Available relevant articles reporting the outcomes of interest were identified and data was extracted. Articles in the reference lists of relevant articles and clinicaltrials.gov were also referenced.

Results: Eleven articles were analyzed with a total of 795 patients identified. Studies showed that select nervous stimulation treatments significantly reduced seizure frequency in patients with DRE.

Keywords: anterior nucleus thalami; deep brain stimulation; drug-resistant epilepsy; post-traumatic epilepsy; repetitive transcranial magnetic stimulation; responsive cortical neurostimulation; transcranial direct current stimulation; vagus nerve stimulation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Search Flow Diagram
Figure 2
Figure 2. Vagal Nerve Stimulator
Case courtesy of Dr. Jayanth Keshavamurthy; Radiopaedia.org, rID: 26836
Figure 3
Figure 3. Deep Brain Stimulation
Case courtesy of A.Prof Frank Gaillard; Radiopaedia.org, rID: 2743
Figure 4
Figure 4. Responsive Neurostimulation
Figure 5
Figure 5. rTMS Device (Left), tDCS Device (Right)
See this image and copyright information in PMC

References

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    1. Epilepsy after head injury: an overview. Lowenstein DH. Epilepsia. 2009;50 Suppl 2:4–9. - PubMed
    1. Epileptogenic focus localization in treatment-resistant post-traumatic epilepsy. Irimia A, Van Horn JD. J Clin Neurosci. 2015;22:627–631. - PMC - PubMed

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