Different modalities of invasive neurostimulation for epilepsy
Epilepsy affects 1% of the general population, about one-third of which is pharmacologically resistant. Uncontrolled seizures are associated with an increased risk of traumatic injury and sudden unexpected death of epilepsy. There is a considerable psychological and financial burden on caregivers of...
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Veröffentlicht in: | Neurological sciences 2020-12, Vol.41 (12), p.3527-3536 |
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description | Epilepsy affects 1% of the general population, about one-third of which is pharmacologically resistant. Uncontrolled seizures are associated with an increased risk of traumatic injury and sudden unexpected death of epilepsy. There is a considerable psychological and financial burden on caregivers of patients with epilepsy, particularly among pediatric patients. Epilepsy surgery, when indicated, is the most promising cure for epilepsy. However, when surgery is contraindicated or refused by the patient, neurostimulation is an alternative palliative approach, albeit with a lower chance of entirely curing patients of seizures. There are many options for neurostimulation. The three most commonly used invasive neurostimulation procedures that consistently show evidence of being safe and efficacious are vagal nerve stimulation, responsive neuro stimulation, or anterior thalamic nucleus deep brain stimulation. The goal of this review is to summarize the current evidence supporting the use of these three techniques, which are approved by most regulatory bodies, and discuss different factors that may enable epilepsy surgeons to choose the most appropriate modality for each patient. |
doi_str_mv | 10.1007/s10072-020-04614-z |
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Uncontrolled seizures are associated with an increased risk of traumatic injury and sudden unexpected death of epilepsy. There is a considerable psychological and financial burden on caregivers of patients with epilepsy, particularly among pediatric patients. Epilepsy surgery, when indicated, is the most promising cure for epilepsy. However, when surgery is contraindicated or refused by the patient, neurostimulation is an alternative palliative approach, albeit with a lower chance of entirely curing patients of seizures. There are many options for neurostimulation. The three most commonly used invasive neurostimulation procedures that consistently show evidence of being safe and efficacious are vagal nerve stimulation, responsive neuro stimulation, or anterior thalamic nucleus deep brain stimulation. 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Uncontrolled seizures are associated with an increased risk of traumatic injury and sudden unexpected death of epilepsy. There is a considerable psychological and financial burden on caregivers of patients with epilepsy, particularly among pediatric patients. Epilepsy surgery, when indicated, is the most promising cure for epilepsy. However, when surgery is contraindicated or refused by the patient, neurostimulation is an alternative palliative approach, albeit with a lower chance of entirely curing patients of seizures. There are many options for neurostimulation. The three most commonly used invasive neurostimulation procedures that consistently show evidence of being safe and efficacious are vagal nerve stimulation, responsive neuro stimulation, or anterior thalamic nucleus deep brain stimulation. The goal of this review is to summarize the current evidence supporting the use of these three techniques, which are approved by most regulatory bodies, and discuss different factors that may enable epilepsy surgeons to choose the most appropriate modality for each patient.</description><subject>Child</subject><subject>Convulsions & seizures</subject><subject>Deep Brain Stimulation</subject><subject>Epilepsy</subject><subject>Epilepsy - therapy</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Palliative Care</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Psychiatry</subject><subject>Review Article</subject><subject>Seizures</subject><subject>Seizures - therapy</subject><subject>Surgery</subject><subject>Thalamus</subject><subject>Vagus nerve</subject><subject>Vagus Nerve Stimulation</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kE1LxDAQhoMo7vrxBzxIwYuX6iRpm-xFkPUTFrzoOaTtRLL0y6Rd2P31Zu2q4MFLJpBn3sk8hJxRuKIA4tpvTxYDgxiSjCbxZo9MaTqDmCdC7u_uVIpkQo68XwIATSg_JBPORAJylk3JzZ01Bh02fVS3pa5sb9FHrYlss9LerjBqcHCt7209VLq3bROZ1kXY2Qo7vz4hB0ZXHk939Zi8Pdy_zp_ixcvj8_x2ERdcpH3MaWFomWvJNSslMI2mSKlhRlIomRF5ymaoJaSJ1iWwLM-F1EhzzJnJUWT8mFyOuZ1rPwb0vaqtL7CqdIPt4BVLOFCgPEsDevEHXbaDa8LvAiVoyrKZZIFiI1WE5bxDozpna-3WioLaelWjXRXsqi-7ahOaznfRQ15j-dPyrTMAfAR8eGre0f3O_if2E403hkU</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>A Alomar, Soha</creator><creator>J Saeedi, Rothaina</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5996-6764</orcidid></search><sort><creationdate>20201201</creationdate><title>Different modalities of invasive neurostimulation for epilepsy</title><author>A Alomar, Soha ; J Saeedi, Rothaina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-31cf1dba83a2d802aefc51f2f810d2f7b529ea8054aad026bb78ae1beb2fbe763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Child</topic><topic>Convulsions & seizures</topic><topic>Deep Brain Stimulation</topic><topic>Epilepsy</topic><topic>Epilepsy - therapy</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Palliative Care</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Psychiatry</topic><topic>Review Article</topic><topic>Seizures</topic><topic>Seizures - therapy</topic><topic>Surgery</topic><topic>Thalamus</topic><topic>Vagus nerve</topic><topic>Vagus Nerve Stimulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>A Alomar, Soha</creatorcontrib><creatorcontrib>J Saeedi, Rothaina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Family Health Database (Proquest)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>A Alomar, Soha</au><au>J Saeedi, Rothaina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different modalities of invasive neurostimulation for epilepsy</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>41</volume><issue>12</issue><spage>3527</spage><epage>3536</epage><pages>3527-3536</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><abstract>Epilepsy affects 1% of the general population, about one-third of which is pharmacologically resistant. 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subjects | Child Convulsions & seizures Deep Brain Stimulation Epilepsy Epilepsy - therapy Humans Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Neurosurgery Palliative Care Patients Pediatrics Psychiatry Review Article Seizures Seizures - therapy Surgery Thalamus Vagus nerve Vagus Nerve Stimulation |
title | Different modalities of invasive neurostimulation for epilepsy |
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