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Cerebellar and thalamic stimulation treatment for epilepsy

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Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

The present chapter describes the most important available experimental and clinical evidence on the role of electrical stimulation of the cerebellum or the thalamus in the control of epilepsy. Cerebellum serves as an integrator of sensory information and regulator of motor coordinating and training. The sole output of the cerebellum is inhibitory Purkinje cell projections to deep cerebellar nuclei in the brainstem. Cerebellar stimulation in animal models of epilepsy has given mixed results. Nevertheless, more than 130 epileptic patients have been subjected to cerebellar stimulation and the results from uncontrolled studies have been encouraging. The anterior thalamic nucleus (ATN) is part of the Papez circuit, a group of limbic structures with demonstrated role in epilepsy. The centromedian thalamic nucleus (CMN) is considered part of the thalamic reticular system. Stimulation of either of these nuclei in experimental animals has been associated with considerable antiepileptic effects. On the basis of the research evidence, numerous studies have been done on humans, which gave promising results. Currently, a multicenter trial on stimulation of the ATN, the SANTE trial is in progress in the USA. On the basis of the reported studies, the authors aim to provide insights into how the electrical stimulation of the above structures exerts an antiepileptic effect and also provide suggestions regarding the future progress in this field.

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Authors and Affiliations

  1. Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

    Gregory L. Krauss

  2. Department of Neurology, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    M. Z. Koubeissi

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  1. Gregory L. Krauss
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  2. M. Z. Koubeissi
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Correspondence to Gregory L. Krauss .

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Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

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Krauss, G.L., Koubeissi, M.Z. (2007). Cerebellar and thalamic stimulation treatment 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_40

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  • DOI: https://doi.org/10.1007/978-3-211-33081-4_40

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