- 作者：Antonio Valent¨ªn ; Huy Q. Nguyen ; Alena M. Skupenova ; Zaloa Agirre-Arrizubieta ; Sharon Jewell ; N ; ini Mullatti ; Nicholas F. Moran ; Mark P. Richardson ; Richard P. Selway ; Gonzalo Alarc¨®n
- 关键词：deep brain stimulation ; refractory status epilepticus ; epilepsy treatment ; electrical stimulation ; centromedian thalamus ; seizures
- 刊名：Brain Stimulation
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：5
- 期：4
- 页码：594-598
- 全文大小：466 K
Background
Refractory status epilepticus (RSE) is associated with high mortality. We report a potential treatment alternative.Hypothesis
Deep brain stimulation (DBS) of the centromedian thalamic nuclei (CMN) can be effective in the treatment of RSE.
Methods
Report of the evolution of RSE after DBS of the CMN in a 27-year-old man.
Results
In the course of an encephalopathy of unknown origin, and after a cardiac arrest, the patient developed RSE with myoclonic jerks and generalized tonic-clonic seizures. The EEG showed continuous generalized periodic epileptiform discharges (GPEDS). Five weeks after RSE onset, bilateral DBS of the CMN was started. This treatment was immediately followed by disappearance of tonic-clonic seizures and GPEDS, suggesting a resolution of RSE. The patient continued having multifocal myoclonic jerks, probably subcortical in origin, which resolved after 4 weeks. The patient remained clinically stable for 2 months in a persistent vegetative state.
Conclusions
The remission of RSE, the abolition of GPEDS, and the patient survival suggest that DBS of the CMN may be efficacious in the treatment of refractory, generalized status epilepticus.