Abstract
Introduction: Deep brain stimulation is a safe and effective neurointerventional technique for the treatment of movement disorders. Electrical stimulation of subcortical structures may exert a control on seizure generators initiating epileptic activities. The aim of this review is to present the targets of the deep brain stimulation for the treatment of drug-resistant epilepsy.Methods: We performed a structured review of the literature from 1980 to 2018 using Medline and PubMed. Articles assessing the impact of deep brain stimulation on seizure frequency in patients with DRE were selected. Meta-analyses, randomized controlled trials, and observational studies were included.Results: To date, deep brain stimulation of various neural targets has been investigated in animal experiments and humans. This article presents the use of stimulation of the anterior and centromedian nucleus of the thalamus, hippocampus, basal ganglia, cerebellum and hypothalamus. Anterior thalamic stimulation has demonstrated efficacy and there is evidence to recommend it as the target of choice.Conclusion: Deep brain stimulation for seizures may be an option in patients with drug-resistant epilepsy. Anterior thalamic nucleus stimulation could be recommended over other targets.
Highlights
Deep brain stimulation is a safe and effective neurointerventional technique for the treatment of movement disorders
We performed a literature search of the Medline R, Embase R, Index Medicus R, Scopus, and Cochrane databases from January 1980 to October 2018 that incorporated Medical Subject Headings and text words for literature related to “deep brain stimulation” and “drug-resistant epilepsy.”
The scope of Deep brain stimulation (DBS) is increasing rapidly in parallel with the DBS is one of the most remarkable interventions in the history understanding of brain circuitry dysfunction in many pathologies of functional neurosurgery. Whether it will significantly improve the outcomes of drug-resistant epilepsy (DRE) patients remains to be seen
Summary
Deep brain stimulation is a safe and effective neurointerventional technique for the treatment of movement disorders. The fact that the same DBS parameters and targets can benefit different neurological disorders suggests that DBS does not act against the pathophysiology of any specific disorder, but rather modulates existing and active pathologic brain circuits and it is well-tolerated [3]. At least 30% of adults with epilepsy do not achieve seizure control with AEDs [7] and surgery to remove or disconnect the epileptogenic zone is not always an appropriate option [8]. These patients may be candidates for neurostimulation
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