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

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Seizure-European Journal of Epilepsy Pub 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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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.