Deep brain stimulation (DBS) has provided new treatment options for refractory epilepsy; however, treatment outcomes of DBS in refractory epilepsy patients previously treated with vagus nerve stimulation (VNS) have not been clarified. Herein, treatment outcomes of DBS of the anterior nucleus of the thalamus (ANT-DBS) in patients who had previously experienced VNS failure are reported. Seven patients who had previously experienced VNS failure underwent ANT-DBS device implantation. VNS was turned off before DBS device implantation. Monthly seizure counts starting from baseline to 12-18 months after DBS were analyzed. Five (71.3%) of the 7 patients experienced a >50% reduction of seizure counts after DBS; 1 responder reached a seizure-free status after DBS therapy. Of the 2 nonresponders, 1 subject showed improvement in seizure strength and duration, which lessened the impact of the seizures on the patient's quality of life. This is the first study in which favorable outcomes of ANT-DBS surgery were observed in individual patients with refractory epilepsy who had not responded to prior VNS. Further studies with a larger number of subjects and longer follow-up period are needed to confirm the feasibility of ANT-DBS in patients who have previously experienced VNS failure.
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http://dx.doi.org/10.1159/000502344 | DOI Listing |
CNS Neurosci Ther
January 2025
School of Information Science and Engineering, Lanzhou University, Lanzhou, China.
Aims: Drug-refractory epilepsy (DRE) refers to the failure of controlling seizures with adequate trials of two tolerated and appropriately chosen anti-seizure medications (ASMs). For patients with DRE, surgical intervention becomes the most effective and viable treatment, but its success rate is unsatisfactory at only approximately 50%. Predicting surgical outcomes in advance can provide additional guidance to clinicians.
View Article and Find Full Text PDFJ Neurosurg Pediatr
January 2025
2Neurology, UT Southwestern, Dallas, Texas.
Objective: Patients with drug-resistant epilepsy (DRE) are often referred for phase II evaluation with stereo-electroencephalography (SEEG) to identify a seizure onset zone for guiding definitive treatment. For patients without a focal seizure onset zone, neuromodulation targeting the thalamic nuclei-specifically the centromedian nucleus, anterior nucleus of the thalamus, and pulvinar nucleus-may be considered. Currently, thalamic nuclei selection is based mainly on the location of seizure onset, without a detailed evaluation of their network involvement.
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December 2024
Health Via Modern Nutrition Inc. (H.V.M.N.), San Francisco, CA, United States.
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View Article and Find Full Text PDFClin Genet
January 2025
Rosamund Stone Zander Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA.
Kleefstra syndrome (KLEFS) is a genetic neurodevelopmental disorder caused by haploinsufficiency of EHMT1. The full spectrum of clinical features and genotype-phenotype correlations is currently not fully understood. We performed a retrospective chart review of patients with KLEFS evaluated at the Boston Children's Hospital Kleefstra Clinic.
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