Surgical techniques and therapeutic effect of deep brain stimulation of anterior nucleus thalamus for refractory partial epilepsy

Abstract

Objective To discuss the surgical techniques and therapeutic effect of deep brain stimulation of anterior nucleus thalamus for refractory partial epilepsy. Methods Eight drug-resistant partial epilepsy patients, with no indication of respective surgery, were treated at Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University from March 2015 to November 2016 and retrospectively enrolled into this study. The seizure frequency, severity of seizure, quality of life, depression and anxiety status and other clinical outcome features in pre-surgical and post-surgical periods were analyzed. Results Eight patients with refractory partial epilepsy were followed up for 18.0±2.4 months. The seizure frequency post surgery was significantly reduced (36.4±13.4 times per month prior to operation, 13.9±6.2 times per month post operation, P=0.012) and the remission rate was 54.3%±7.4%. The severity of seizure was improved based on the Liverpool seizure severity scale (38.4±5.3 points prior to operation, 22.3±4.9 points post operation, P=0.001) and the remission rate was 46.0%±8.4%. The quality of life was significantly improved based on the Quality of Life in Epilepsy Inventory-89 (71.2±2.7 points prior to operation, 80.0±2.9 points post operation, P=0.001) and the improvement rate was 12.6%±2.3%. Conclusion For patients with refractory partial epilepsy without indication of respective surgery, deep brain stimulation of anterior nucleus thalamus might have certain treatment effect, which still needs further clinical research. Key words: Epilepsy, partial; Anterior thalamic nuclei; Deep brain stimulation; Treatment outcome