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


Imbach, Lukas L; Baumann, Christian R; Poryazova, Rositsa; Geissler, Olivia; Brugger, Peter; Sarnthein, Johannes; Mothersill, Ian; Weller, Michael; Oertel, Markus F; Stieglitz, Lennart H (2019). Anticonvulsive effect of anterior thalamic deep brain stimulation in super-refractory status epilepticus crucially depends on active stimulation zone—A single case observation. Seizure, 71:286-288.

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, Lehtimäki 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.

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, Lehtimäki 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.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Neurology
Health Sciences > Neurology (clinical)
Uncontrolled Keywords:Neurology, Clinical Neurology, General Medicine, Deep brain stimulation; Status epilepticus; Epilepsy; Anterior nucleus of the thalamus
Language:English
Date:1 October 2019
Deposited On:17 Oct 2019 08:29
Last Modified:29 Jul 2020 11:29
Publisher:Elsevier
ISSN:1059-1311
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.seizure.2019.08.015
PubMed ID:31493681

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