• Neurosurgery · Oct 2020

    Case Reports

    Responsive Neurostimulation of the Thalamus Improves Seizure Control in Idiopathic Generalized Epilepsy: A Case Report.

    • Vasileios Kokkinos, Alexandra Urban, Nathaniel D Sisterson, Ningfei Li, Danielle Corson, and R Mark Richardson.
    • Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
    • Neurosurgery. 2020 Oct 15; 87 (5): E578-E583.

    Background And ImportanceAt least 25% of patients with idiopathic generalized epilepsy do not obtain adequate seizure control with medication. This report describes the first use of responsive neurostimulation (RNS), bilaterally targeting the centromedian/ventrolateral (CM/VL) region in a patient with drug-refractory Jeavons syndrome (eyelid myoclonia with absences).Clinical PresentationA patient, diagnosed with eyelid myoclonia with absences (EMA) and refractory to medication, was offered RNS treatment in the CM/VL region of the thalamus. Stimulation was triggered by thalamic neural activity having morphological, spectral, and synchronous features that corresponded to 3- to 5-Hz spike-wave discharges recorded on prior scalp electroencephalography.ConclusionRNS decreased daily absence seizures from a mean of 60 to ≤10 and maintained the patient's level of consciousness during the occurring episodes. This therapy should be evaluated further for its potential to treat patients with pharmaco-refractory generalized epilepsy.Copyright © 2020 by the Congress of Neurological Surgeons.

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