Experimental Electrical Stimulation Therapy for Epilepsy.

Stanford Department of Neurology, Room A343, Stanford Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA. .
Current Treatment Options in Neurology (Impact Factor: 1.94). 08/2005; 7(4):261-271. DOI: 10.1007/s11940-005-0036-9
Source: PubMed

ABSTRACT Electrical stimulation of the nervous system is an attractive possible therapy for intractable epilepsy, but only stimulation of the vagus nerve has been subjected to large, controlled, and completed clinical trials. Controlled trials are in progress for intermittent cycling stimulation of the anterior nuclei of the thalamus, and for cortical stimulation at a seizure focus, responsive to detection of seizure onset. Anecdotal experience has been gathered with stimulation of cerebellum, centromedian thalamus, subthalamus, caudate, hippocampus, and brainstem. All stimulation of the central nervous system for epilepsy must be considered experimental.

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    ABSTRACT: Objectives:  Epilepsy continues to provide challenges to clinicians, as a significant proportion of patients continue to suffer from seizures despite medical and surgical treatments. Neurostimulation has emerged as a new treatment modality that has the potential to improve quality of life and occasionally be curative for patients with medically refractory epilepsy who are not surgical candidates. In order to continue to advance the frontier of this field, it is imperative to have a firm grasp of the current body of knowledge. Methods:  We performed a thorough review of the current literature regarding the three main modalities of vagus nerve stimulation, deep brain stimulation, and closed-loop stimulation (responsive neurostimulator [RNS]) for the treatment of refractory epilepsy. For each of these forms of treatment, we discuss the current understanding of the underlying mechanism of action, patient selection, outcomes to date, and associated side effects or adverse reactions. We also provide an overview of related ongoing clinical trials. Results:  A total of 189 sources from 1938 to 2012 pertaining to neuromodulation for the treatment of epilepsy were reviewed. Sources included review articles, clinical trials, case reports, conference proceedings, animal studies, and government data bases. Conclusions:  This review shows us how neurostimulation provides us with yet another tool with which to treat the complex disease of medically refractory epilepsy.
    Neuromodulation 09/2012; 16(1). DOI:10.1111/j.1525-1403.2012.00501.x · 1.79 Impact Factor