Anticonvulsive effect of anterior thalamic deep brain stimulation in super-refractory status epilepticus crucially depends on active stimulation zone—A single case observation

Abstract

Super-refractory status epilepticus has a high mortality, and its treatment remains a challenge for clinical epileptologists. Deep brain stimulation (DBS) is successfully used in pharmacotherapy-resistant epilepsy andlargerstudies showed significant seizure reduction byhigh frequency stimulation in the anterior nucleus of the thalamus (ANT) [1]. Furthermore, several case reports indicate that DBS is also effective in the management of status epilepticus. In a recent, very comprehensive publication, Lehtimaki et al. reported resolution of a super-refractory non-convulsive status epilepticus with continuous high-frequency stimulation of the centromedian thalamic nucleus [2]. Other groups found beneficial effects in the centromedian thalamus and recently also in the ANT in generalized or focal status epilepticus [3]. These cases emphasize the feasibility to interact with and eventually disrupt ongoing cortical epileptic activity by DBS. Here we report a case of a patient with multiple episodes of nonconvulsive status epilepticus who was sucessfully treated with bilateral ANT-DBS.