Deep Brain Stimulation for Refractory Focal Epilepsy: Unraveling the Insertional Effect up to Five Months Without Stimulation

Abstract Objective Headache disorders are frequently associated with epilepsy. Some neuromodulation techniques for refractory epilepsy have been reported to positively influence the associated chronic headache. However, the exact mechanism of action of vagus nerve stimulation (VNS) and anterior thalamic nuclei-deep brain stimulation (ANT-DBS) on pain perception is unclear. Method We report a structured assessment of pain perception in a patient who experienced headache relief after ANT-DBS for refractory focal epilepsy and compare it with pain perception of epilepsy patients with chronic headache who were treated with and without VNS. Results The pain-associated symptoms in the ANT-DBS case were on the Pain Anxiety Symptoms Scale (PASS-40) subscore “physiological anxiety” closer to the control collective, whereas in patients with VNS, this was more likely for the PASS-40 subscores “cognitive anxiety” or “escape and avoidance.” Conclusion ANT-DBS and VNS may influence epilepsy-associated chronic headache in different ways.

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Epilepsy Treatment Stimulus Package? Deep Brain Stimulation in Treatment-Resistant Focal Epilepsy

Epilepsy Currents ◽

10.1111/j.1535-7511.2010.01384.x ◽

2010 ◽

Vol 10 (6) ◽

pp. 148-150 ◽

Cited By ~ 1

Author(s):

Chad Carlson

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Focal Epilepsy ◽

Treatment Resistant ◽

Epilepsy Treatment ◽

Deep Brain ◽

Stimulus Package

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Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Unipolar and Bipolar Depression

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2012.05.058 ◽

2012 ◽

Vol 2012 ◽

pp. 241-243

Author(s):

P. House

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Bipolar Depression ◽

Treatment Resistant ◽

Deep Brain

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Deep Brain Stimulation Aids Resistant Depression

Internal Medicine News ◽

10.1016/s1097-8690(08)71087-4 ◽

2008 ◽

Vol 41 (19) ◽

pp. 20

Author(s):

MICHELE G. SULLIVAN

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Resistant Depression ◽

Deep Brain

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Nicht-medikamentöse Optionen zur Behandlung pharmakoresistenter Epilepsien

Therapeutische Umschau ◽

10.1024/0040-5930/a001023 ◽

2018 ◽

Vol 75 (7) ◽

pp. 448-454

Author(s):

Thomas Grunwald ◽

Judith Kröll

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Tiefe Hirnstimulation ◽

Ketogene Diät ◽

Deep Brain

Zusammenfassung. Wenn mit den ersten beiden anfallspräventiven Medikamenten keine Anfallsfreiheit erzielt werden konnte, so ist die Wahrscheinlichkeit, dies mit anderen Medikamenten zu erreichen, nur noch ca. 10 %. Es sollte dann geprüft werden, warum eine Pharmakoresistenz besteht und ob ein epilepsiechirurgischer Eingriff zur Anfallsfreiheit führen kann. Ist eine solche Operation nicht möglich, so können palliative Verfahren wie die Vagus-Nerv-Stimulation (VNS) und die tiefe Hirnstimulation (Deep Brain Stimulation) in eine bessere Anfallskontrolle ermöglichen. Insbesondere bei schweren kindlichen Epilepsien stellt auch die ketogene Diät eine zu erwägende Option dar.

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