Abstract
Deep brain stimulation (DBS), which mimics the effect of ablative surgery in movement disorders, is considered by analogy as potentially useful in the epileptic temporal lobe as an alternative to resection. It could be applied to patients in whom resective surgery is less beneficial, e.g. cases without memory impairment or with bilateral hippocampal involvement. In patients who undergo invasive presurgical analysis, the necessary intrahippocampal leads can serve for the application of DBS, provided that they are suited for chronic use. The hippocampus, in which the focus of epilepsy is detected, is stimulated continuously using high-frequency square-wave pulses. The reduction of interictal spike activity during a period of acute stimulation is the criterion for deciding whether the leads will be connected to an internal pulse generator. We are conducting a pilot study, with 16 patients enrolled so far, ten of whom have been followed up for more than one year. Some theoretical considerations are dedicated to hippocampal DBS.
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References
Benabid AL, Koudsie A, Benazzouz A, Vercueil L, Fraix V, Chabardes S, Lebas JF, Pollak P (2001) Deep brain stimulation of the corpus luysi (subthalamic nucleus) and other targets in Parkinson’s disease. Extension to new indications such as dystonia and epilepsy. J Neurol 248Suppl 3: 37–47
Chkhenkeli SA, Chkhenkeli IS (1997) Effects of therapeutic stimulation of nucleus caudatus on epileptic electrical activity of brain in patients with intractable epilepsy. Stereotact Funct Neurosurg 69: 221–224
Chkhenkeli SA, Šramka M, Lortkipanidze GS, Rakviashvili TN, Bregvadze ES, Magalashvili GE, Gagoshidze TS, Chkhenkeli IS (2004) Electrophysiological effects and clinical results of direct brain stimulation for intractable epilepsy. Clin Neurol Neurosurg 106: 318–329
Cooper IS, Upton AR (1978) Effects of cerebellar stimulation on epilepsy, the EEG and cerebral palsy in man. Electroencephalogr Clin Neurophysiol Suppl 34: 349–354
Feinstein B, Gleason CA, Libet B (1989) Stimulation of locus coeruleus in man. Preliminary trials for spasticity and epilepsy. Stereotact Funct Neurosurg 52: 26–41
Fisher RS, Uematsu S, Krauss GL, Cysyk BJ, McPherson R, Lesser RP, Gordon B, Schwerdt P, Rise M (1992) Placebo-controlled pilot study of centromedian thalamic stimulation in treatment of intractable seizures. Epilepsia 33: 841–851
Fountas KN, Smith JR, Murro AM, Politsky J, Park YD, Jenkins PD (2005) Implantation of a closed-loop stimulation in the management of medically refractory focal epilepsy. A Technical Note. Stereotact Funct Neurosurg 83: 153–158
Gleissner U, Helmstaedter C, Schramm J, Elger CE (2002) Memory outcome after selective amygdalohippocampectomy: a study in 140 patients with temporal lobe epilepsy. Epilepsia 43: 87–95
Helmstaedter C, Van Roost D, Clusmann H, Urbach H, Elger CE, Schramm J (2004) Collateral brain damage, a potential source of cognitive impairment after selective surgery for control of mesial temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 75: 323–326
Hodaie M, Wennberg RA, Dostrovsky JO, Lozano AM (2002) Chronic anterior thalamus stimulation for intractable epilepsy. Epilepsia 43: 603–608
Lunsford LD, Latchaw RE, Vries JK (1983) Stereotactic implantation of deep brain electrodes using computed tomography. Neurosurgery 13: 280–286
Musolino A, Tournoux P, Missir O, Talairach J (1990) Methodology of “in vivo” anatomical study and stereo-electroencephalographic exploration in brain surgery for epilepsy. J Neuroradiol 17: 67–10
Paglioli E, Palmini A, Paglioli E, da Costa JC, Portuguez M, Martinez JV, Calcagnotto ME, Hoefel JR, Raupp S, Barbosa-Coutinho L (2004) Survival analysis of the surgical outcome of temporal lobe epilepsy due to hippocampal sclerosis. Epilepsia 45: 1383–1391
Penry JK, Dean JC (1990) Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results. Epilepsia 31Suppl: 40–43
Régis J, Rey M, Bartolomei F, Vladyka V, Liscak R, Schrottner O, Pendl G (2004) Gamma knife surgery in mesial temporal lobe epilepsy: a prospective multicenter study. Epilepsia 45: 504–515
Šramka M, Fritz G, Gajdosova D, Nadvornik P (1980) Central stimulation treatment of epilepsy. Acta Neurochir Suppl 30: 183–187
Spencer DD, McCarthy G, Luby ML, Spencer SS (1994) MRI stereotactic placement of intracranial electrodes. In: Shorvon SD, Fish DR, Andermann F, Bydder GM, Stefan H (eds) Magnetic resonance scanning and epilepsy. Plenum Press, New York, pp 149–153
Tellez-Zenteno JF, Dhar R, Wiebe S (2005) Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain 128: 1188–1198
Upton AR, Cooper IS, Springman M, Amin I (1985–86) Suppression of seizures and psychosis of limbic system origin by chronic stimulation of anterior nucleus of the thalamus. Int J Neurol 19–20: 223–230
Van Roost D, Solymosi L, Schramm J, van Oosterwyck B, Elger CE (1998) Depth electrode implantation in the length axis of the hippocampus for the presurgical evaluation of medial temporal lobe epilepsy: a computed tomography-based stereotactic insertion technique and its accuracy. Neurosurgery 43: 819–827
van Veelen CWM, Debets RMC, van Huffelen AC, van Emde Boas W, Binnie CD, Storm van Leeuwen W, Velis DN, van Dieren A (1990) Combined use of subdural and intracerebral electrodes in preoperative evaluation of epilepsy. Neurosurgery 26: 93–101
Velasco AL, Velasco M, Velasco F, Menes D, Gordon F, Rocha L, Briones M, Márquez I (2000) Subacute and chronic electrical stimulation of the hippocampus on intractable temporal lobe seizures: preliminary report. Arch Med Res 31: 316–328
Velasco F, Velasco M, Jiménez F, Velasco AL, Brito F, Rise M, Carrillo-Ruiz JD (2000) Predictors in the treatment of difficult-tocontrol seizures by electrical stimulation of the centromedian thalamic nucleus. Neurosurgery 47: 295–304
Velasco F, Velasco M, Velasco AL, Jiménez F, Márquez I, Rise M (1995) Electrical stimulation of the centromedian thalamic nucleus in control of seizures: long-term studies. Epilepsia 36: 63–71
Vonck K, Boon P, Achten E, De Reuck J, Caemaert J (2002) Long-term amygdalohippocampal stimulation for refractory temporal lobe epilepsy. Ann Neurol 52: 556–565
Wierenga CJ, Wadman WJ (2003) Functional relation between interneuron input and population activity in the rat hippocampal cornu ammonis 1 area. Neuroscience 118: 1129–1139
Wieser HG, Ortega M, Friedman A, Yonekawa Y (2003) Long-term seizure outcomes following amygdalohippocampectomy. J Neurosurg 98: 751–763
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Van Roost, D., Boon, P., Vonck, K., Caemaert, J. (2007). Neurosurgical aspects of temporal deep brain stimulation for epilepsy. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_37
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DOI: https://doi.org/10.1007/978-3-211-33081-4_37
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