Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy: A Canadian Experience.

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  • Additional Information
    • Source:
      Publisher: published by Cambridge University Press for the Canadian Neurological Sciences Federation Country of Publication: England NLM ID: 0415227 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0317-1671 (Print) Linking ISSN: 03171671 NLM ISO Abbreviation: Can J Neurol Sci Subsets: MEDLINE
    • Publication Information:
      Publication: <1999>- : Cambridge : published by Cambridge University Press for the Canadian Neurological Sciences Federation
      Original Publication: Calgary : Canadian Journal of Neurological Sciences
    • Subject Terms:
      Anterior Thalamic Nuclei* ; Deep Brain Stimulation* ; Epilepsy*/therapy ; Vagus Nerve Stimulation*; Canada ; Humans ; Treatment Outcome
    • Abstract:
      Objective: To describe the experience with Anterior Nucleus of the Thalamus-Deep Brain Stimulation (ANT-DBS) for the treatment of epilepsy at a Canadian Center.
      Methods: All patients who underwent ANT-DBS implantation between 2013 (first patient implanted at our center) and 2020 were included. These patients had therapy-resistant epilepsy (TRE), were not candidates for resective surgery, and failed vagus nerve stimulation (VNS) treatment. Baseline of monthly seizure frequency was calculated within 3 months prior to VNS placement. Monthly seizure frequency was assessed at different points along the timeline: 3 months before ANT-DBS implantation as well as 3, 6, 12, 24, 36, 48, 60, and 72 months after ANT-DBS device placement. At each time point, seizure frequency was compared to baseline.
      Results: Six patients were implanted with ANT-DBS. Three (50%) patients had multifocal epilepsy, one (16.6%) had focal epilepsy, and two (33.4%) had combined generalized and focal epilepsy. Two patients with multifocal epilepsy experienced a seizure reduction >50% in the long-term follow-up. Three (50%) patients did not showed improvement: two with combined generalized and focal epilepsy and one with focal epilepsy. There were not surgical or device-related side effects. Two (33.3%) patients presented mild and transient headaches as a stimulation-related side effect.
      Conclusion: ANT-DBS is an effective and safe treatment for focal TRE. Our experience suggests that patients with multifocal epilepsy due to regional lesion may benefit from ANT-DBS the most. Further investigations are required to determine optimal parameters of stimulation.
    • Contributed Indexing:
      Keywords: Deep brain stimulation; Epilepsy; Epilepsy surgery; Thalamus
    • Publication Date:
      Date Created: 20201016 Date Completed: 20210929 Latest Revision: 20210929
    • Publication Date:
      20231215
    • Accession Number:
      10.1017/cjn.2020.230
    • Accession Number:
      33059773