丘脑中央核反应性神经刺激治疗儿童耐药全身性癫痫：7例患者的病例系列。

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Epilepsy Research Pub Date : 2025-02-01 DOI:10.1016/j.eplepsyres.2025.107516

Mikaela E. Speakes , Kiersten Reznik-Schaefer , Ruba Al-Ramadhani , Luis D. Fernandez , Jasmine L. Hect , Taylor J. Abel , William P. Welch

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引用次数: 0

摘要

目的：反应性神经刺激丘脑中央核（CM RNS）治疗耐药全面性癫痫的研究结果令人鼓舞。本研究的目的是报告7例儿科发病的耐药全面性癫痫患者的结局，包括遗传性全面性癫痫（GGE）和Lennox-Gastaut综合征（LGS），他们接受了双侧CM RNS治疗。方法：对2020 - 2022年在匹兹堡儿童医院接受双侧CM RNS治疗的耐药全面性癫痫患者进行回顾性图表分析。通过患者和/或护理人员对标准化患者问卷的报告，癫痫发作频率得到改善。主要结果测量是与基线癫痫发作频率相比，最后一次随访预约时癫痫发作频率的改善百分比。结果：7例患者中有5例（71 %）癫痫发作频率平均改善50% %或以上，其中GGE 5例中有4例（80 %），LGS 2例中有1例（50 %）。没有严重的不良事件，包括术后感染、中风或设备故障/移动。结论：这一数据以及最近的其他研究表明，CM RNS可以改善儿科起病的耐药全面性癫痫的发作频率，但需要更大规模的系统研究、更长的随访时间和标准化的结果测量来确定丘脑RNS的长期有效性和最佳患者选择。

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Treatment of pediatric drug-resistant generalized epilepsy with responsive neurostimulation of the centromedian nucleus of the thalamus: A case series of seven patients

Purpose

Responsive neurostimulation of the centromedian nucleus of the thalamus (CM RNS) is being investigated for treatment of drug-resistant generalized epilepsy with promising results. The aim of this study is to report outcomes of seven patients with pediatric-onset drug-resistant generalized epilepsy, including both genetic generalized epilepsy (GGE) and Lennox-Gastaut syndrome (LGS), who underwent treatment with bilateral CM RNS.

Methods

A retrospective chart review was performed for patients with drug-resistant generalized epilepsy who underwent treatment with bilateral CM RNS at Children’s Hospital of Pittsburgh from 2020 to 2022. Improvement in seizure frequency was obtained through patient and/or caregiver reports on standardized patient questionnaires. The primary outcome measure was percent improvement in seizure frequency at time of last follow-up appointment compared to baseline seizure frequency.

Results

Five of the seven patients (71 %) had an average 50 % or greater improvement in seizure frequency among seizure types including four of the five patients (80 %) with GGE and one of the two patients (50 %) with LGS. There were no serious adverse events including post-operative infection, stroke, or device malfunction/migration.

Conclusion

This data, along with other recent studies, suggests that CM RNS can improve seizure frequency in pediatric-onset drug-resistant generalized epilepsy, but larger systematic studies with longer follow-up times and standardized outcome measures are needed to determine long-term effectiveness and optimal patient selection for thalamic RNS.

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来源期刊

Epilepsy Research 医学-临床神经学

CiteScore

0.10

自引率

4.50%

发文量

143

审稿时长

62 days

期刊介绍： Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.