Clinical study on treatment of drug-resistant epilepsy with deep brain stimulation in bilateral anterior thalamic nuclei

Objective To study the efficacy and possible mechanism of deep brain stimulation (DBS) in bilateral anterior thalamic nuclei (ATN) for drug-resistant epilepsy. Methods Three cases with drug-resistant epilepsy underwent DBS in bilateral ATN. Preoperative and postoperative assessment included the frequency of seizures, seizure types, kinds and dosage of anti-epileptic drugs (AEDs), and imaging and EEG examination. Results Case 1 was followed up for 28 months, with only one seizure attack occurred due to missing doses. Video EEG (VEEG) during the follow-up period showed that a single unilateral spike-slow wave discharge was found by accident in one year after DBS. As for Case 2, intermittent time was significantly prolonged during the follow-up of 24 months. VEEG during the follow-up period showed interictal right frontal-central-parietal slow wave. Case 3 was followed up for 3 months, and VEEG examination during the follow-up period revealed decrease of diffuse spike-slow wave, while bilateral occipital spike-slow wave could be seen in interictal phase. Without any change of type and dose in taking AEDs after DBS, seizure frequency was reduced by 100% in Case 1, 25% in Case 2, and almost 55% in Case 3. Conclusions DBS therapy is an effective treatment for drug-resistant epilepsy. It could significantly reduce the frequency of attacks, or even completely control the attack, and improve the patients' quality of life. DOI: 10.3969/j.issn.1672-6731.2015.09.007