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      The Role of Anterior Thalamic Deep Brain Stimulation as an Alternative Therapy in Patients with Previously Failed Vagus Nerve Stimulation for Refractory Epilepsy.

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          Abstract

          Deep brain stimulation (DBS) has provided new treatment options for refractory epilepsy; however, treatment outcomes of DBS in refractory epilepsy patients previously treated with vagus nerve stimulation (VNS) have not been clarified. Herein, treatment outcomes of DBS of the anterior nucleus of the thalamus (ANT-DBS) in patients who had previously experienced VNS failure are reported. Seven patients who had previously experienced VNS failure underwent ANT-DBS device implantation. VNS was turned off before DBS device implantation. Monthly seizure counts starting from baseline to 12-18 months after DBS were analyzed. Five (71.3%) of the 7 patients experienced a >50% reduction of seizure counts after DBS; 1 responder reached a seizure-free status after DBS therapy. Of the 2 nonresponders, 1 subject showed improvement in seizure strength and duration, which lessened the impact of the seizures on the patient's quality of life. This is the first study in which favorable outcomes of ANT-DBS surgery were observed in individual patients with refractory epilepsy who had not responded to prior VNS. Further studies with a larger number of subjects and longer follow-up period are needed to confirm the feasibility of ANT-DBS in patients who have previously experienced VNS failure.

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          Author and article information

          Journal
          Stereotact Funct Neurosurg
          Stereotactic and functional neurosurgery
          S. Karger AG
          1423-0372
          1011-6125
          2019
          : 97
          : 3
          Affiliations
          [1 ] Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea.
          [2 ] Department of Nursing, Samsung Medical Center, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Republic of Korea.
          [3 ] Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
          [4 ] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
          [5 ] Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
          [6 ] Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea, shben.lee@samsung.com.
          [7 ] Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, shben.lee@samsung.com.
          Article
          000502344
          10.1159/000502344
          31533117
          24448215-5b03-4ee9-b52a-83c24901db6d
          History

          Anterior thalamic nucleus,Deep brain stimulation,Neuromodulation,Failed vagus nerve stimulation,Refractory epilepsy

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