Responsive Neurostimulation of the Thalamus Improves Seizure Control in Idiopathic Generalized Epilepsy: A Case Report. Issue 5 (5th February 2020)

• Record Type: Journal Article
• Authors: Kokkinos, Vasileios; Urban, Alexandra; Sisterson, Nathaniel D; Li, Ningfei; Corson, Danielle; Richardson, R Mark
• Is Part Of: Neurosurgery. Volume 87:Issue 5(2020)
• Page Start: E578
• Page End: E583
• Publication Date: 2020-02-05
• Subjects: Generalized epilepsy -- Responsive neurostimulation -- Centromedian nucleus -- Thalamus; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa001
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND AND IMPORTANCE: At least 25% of patients with idiopathic generalized epilepsy do not obtain adequate seizure control with medication. This report describes the first use of responsive neurostimulation (RNS), bilaterally targeting the centromedian/ventrolateral (CM/VL) region in a patient with drug-refractory Jeavons syndrome (eyelid myoclonia with absences). CLINICAL PRESENTATION: A patient, diagnosed with eyelid myoclonia with absences (EMA) and refractory to medication, was offered RNS treatment in the CM/VL region of the thalamus. Stimulation was triggered by thalamic neural activity having morphological, spectral, and synchronous features that corresponded to 3- to 5-Hz spike-wave discharges recorded on prior scalp electroencephalography. CONCLUSION: RNS decreased daily absence seizures from a mean of 60 to ≤10 and maintained the patient's level of consciousness during the occurring episodes. This therapy should be evaluated further for its potential to treat patients with pharmaco-refractory generalized epilepsy.