病例报告:边缘网络癫痫与精神、记忆和睡眠合并症的衔接:连续高频 ANT-DBS 治疗期间出现可逆性精神病症状的病例说明

Lydia P. Wheeler, Samuel Worrell, I. Balzekas, Jordan Bilderbeek, Dora Hermes, Paul E. Croarkin, Steven Messina, Jamie J Van Gompel, Kai J. Miller, V. Kremen, Gregory A Worrell
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引用次数: 0

摘要

局灶性癫痫的网络性质以颞叶中叶癫痫(mTLE)为例,其特点是局灶性癫痫发作源自颞叶中叶新皮质、杏仁核和海马。mTLE 网络假说在癫痫发作的半身性和发作间期的合并症中表现明显,两者都反映了边缘网络功能障碍。产生癫痫发作的网络也支持重要的生理功能,包括记忆、情感、情绪和睡眠。mTLE 网络的病理变化通常表现为发作间期行为紊乱和癫痫发作。边缘回路是一个重要的网络,在此我们回顾了最常见的局灶性癫痫之一及其合并症。我们描述了两名植入了可实现连续海马局部场电位感应和丘脑前核深部脑刺激(ANT-DBS)研究设备的耐药 mTLE 患者,他们在连续高频刺激期间出现了可逆性精神病。我们在此推测,高频 ANT-DBS 的抗癫痫作用可能有助于了解与精神病相关的原发性疾病的生理学。
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Case report: Bridging limbic network epilepsy with psychiatric, memory, and sleep comorbidities: case illustrations of reversible psychosis symptoms during continuous, high-frequency ANT-DBS
The network nature of focal epilepsy is exemplified by mesial temporal lobe epilepsy (mTLE), characterized by focal seizures originating from the mesial temporal neocortex, amygdala, and hippocampus. The mTLE network hypothesis is evident in seizure semiology and interictal comorbidities, both reflecting limbic network dysfunction. The network generating seizures also supports essential physiological functions, including memory, emotion, mood, and sleep. Pathology in the mTLE network often manifests as interictal behavioral disturbances and seizures. The limbic circuit is a vital network, and here we review one of the most common focal epilepsies and its comorbidities. We describe two people with drug resistant mTLE implanted with an investigational device enabling continuous hippocampal local field potential sensing and anterior nucleus of thalamus deep brain stimulation (ANT-DBS) who experienced reversible psychosis during continuous high-frequency stimulation. The mechanism(s) of psychosis remain poorly understood and here we speculate that the anti-epileptic effect of high frequency ANT-DBS may provide insights into the physiology of primary disorders associated with psychosis.
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