• Arthur Cukiert, Cristine Mella Cukiert, Jose Augusto Burattini, and Alessandra de Moura Lima.
• Clinica de Epilepsia de Sao Paulo, Sao Paulo, SP, Brazil.
• Neuromodulation. 2015 Aug 1; 18 (6): 439-41; discussion 441.

ObjectiveWe studied patients treated with chronic DBS in whom there was depletion of the generator's battery, in order to get insight on the modulatory potential of chronic DBS in refractory epilepsy.MaterialNine adult patients with refractory epilepsy treated with at least three years of deep brain stimulation (DBS), and who were followed up for at least six months after battery depletion were studied. One patient was treated with hippocampal DBS (Hip-DBS), two to centro-median DBS (CM-DBS) and six to anterior nucleus stimulation (AN-DBS).ResultsTwo patients did not have seizure's frequency modification after battery depletion; the other seven patients had seizure frequency increase, including those three patients that were seizure-free. Five of those seven patients who had seizure frequency increase after battery's depletion had seizure's frequency lower than their pre-DBS baseline seizure frequency; two of such patients returned to their pre-DBS baseline seizure frequency.ConclusionsIn the majority of the patients, three years of chronic DBS did not show a permanent effect on epileptogenesis. On the other hand, the post-battery depletion seizure's frequency was usually much lower than the baseline (pre-DBS) seizure's frequency, suggesting that there was actual network neuromodulation.© 2015 International Neuromodulation Society.

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