Deep brain stimulation of the anterior nucleus of the thalamus reduces the risk for status epilepticus in focal drug-resistant epilepsy

IF 2.8 3区医学 Q2 CLINICAL NEUROLOGY Seizure-European Journal of Epilepsy Pub Date : 2025-03-01 Epub Date: 2025-02-07 DOI:10.1016/j.seizure.2025.02.004

Athina Firtinidou , Lennart Stieglitz , Lukas Imbach

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Abstract

Objective

Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a third-line treatment option for patients with refractory focal epilepsy. However, the effect on recurrent episodes of status epilepticus (SE) after ANT-DBS implantation has not been systematically investigated. Here, we set out to determine whether ANT-DBS has a preventive clinical effect on the risk of SE in difficult-to-treat epilepsies.

Methods

We performed a retrospective, monocentric analysis in a cohort of patients with refractory epilepsy who received bilateral DBS implantation in the ANT (n = 24). Medical records were reviewed to compare the total number of SE in each patient before and after surgery.

Results

Out of 24 patients, 11 (46 %) had 20 episodes of SE preoperatively, 17 of which were unprovoked. Postoperatively, only 2 patients developed SE, one of which was provoked. The relative annual risk of SE in this cohort was reduced from 28.8 % (per patient year) preoperatively to 1.9 % postoperatively, demonstrating a statistically significant reduction in SE incidence with ANT-DBS (p < 0.005). Survival analysis confirmed significantly longer status-free survival postoperatively.

Conclusion

ANT-DBS may be beneficial as a preventive intervention in patients with refractory epilepsy at high risk for recurrent SE.

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深部脑刺激丘脑前核降低局灶性耐药癫痫癫痫持续状态的风险

目的丘脑前核深部脑刺激（DBS）是治疗难治性局灶性癫痫的三线治疗方案。然而，对植入ANT-DBS后癫痫持续状态（SE）复发的影响还没有系统的研究。在这里，我们着手确定ANT-DBS是否对难治性癫痫的SE风险具有预防临床作用。方法：我们对24例接受双侧脑深部脑刺激植入的难治性癫痫患者进行了回顾性单中心分析。回顾医疗记录，比较每位患者手术前后的SE总数。结果24例患者中，11例（46%）术前SE发作20次，其中17例无诱因。术后仅2例出现SE，其中1例为诱发性SE。在该队列中，SE的相对年风险从术前的28.8%（每个患者年）降至术后的1.9%，表明ANT-DBS降低了SE的发病率(p <；0.005)。生存分析证实术后无状态生存时间明显延长。结论抗- dbs对难治性癫痫高复发性SE患者有一定的预防作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seizure-European Journal of Epilepsy 医学-临床神经学

CiteScore

5.60

自引率

6.70%

发文量

231

审稿时长

34 days

期刊介绍： Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.