Current Neurology and Neuroscience Reports

, Volume 11, Issue 4, pp 404–408

Alternative Surgical Approaches in Epilepsy

Article

DOI: 10.1007/s11910-011-0209-8

Cite this article as:
Gigante, P.R. & Goodman, R.R. Curr Neurol Neurosci Rep (2011) 11: 404. doi:10.1007/s11910-011-0209-8

Abstract

The mainstay of epilepsy surgery is the resection of a presumed seizure focus or disruption of seizure propagation pathways. These approaches cannot be applied to all patients with medically refractory epilepsy (MRE). Since 1997, vagus nerve stimulation has been a palliative adjunct to the care of MRE patients. Deep brain stimulation (DBS) in select locations has been reported to reduce seizure frequency in small studies over the past three decades. Recently published results from the SANTE (Stimulation of the Anterior Nuclei of Thalamus for Epilepsy) trial—the first large-scale, randomized, double-blind trial of bilateral anterior thalamus DBS for MRE—demonstrate a significant reduction in seizure frequency with programmed stimulation. Another surgical alternative is the RNS™ System (NeuroPace, Mountain View, CA), which uses a closed-loop system termed responsive neurostimulation to both detect apparent seizure onsets and deliver stimulation. Recently presented results from the RNS™ pivotal trial demonstrate a sustained reduction in seizure frequency with stimulation, although comprehensive trial results are pending.

Keywords

Epilepsy Surgery Neurostimulation 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Neurological SurgeryColumbia UniversityNew YorkUSA
  2. 2.Department of Neurological SurgerySt. Luke’s-RooseveltNew YorkUSA

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