TY - JOUR
T1 - Chronic subthreshold cortical stimulation
T2 - a therapeutic and potentially restorative therapy for focal epilepsy
AU - Lundstrom, Brian Nils
AU - Worrell, Gregory A.
AU - Stead, Matt
AU - Van Gompel, Jamie J.
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2017/7/3
Y1 - 2017/7/3
N2 - Introduction: Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability. The authors review literature related to CSCS. One challenge is finding the most efficacious set of stimulation parameters for each patient. Expert commentary: Data supporting CSCS are limited but promising for the treatment of patients with focal drug resistant epilepsy who are not surgical candidates. Additional electrophysiological biomarkers to estimate cortical excitability are needed.
AB - Introduction: Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability. The authors review literature related to CSCS. One challenge is finding the most efficacious set of stimulation parameters for each patient. Expert commentary: Data supporting CSCS are limited but promising for the treatment of patients with focal drug resistant epilepsy who are not surgical candidates. Additional electrophysiological biomarkers to estimate cortical excitability are needed.
KW - Cortical stimulation
KW - chronic electrical stimulation
KW - drug-resistant epilepsy
KW - focal seizures
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U2 - 10.1080/14737175.2017.1331129
DO - 10.1080/14737175.2017.1331129
M3 - Article
C2 - 28532252
AN - SCOPUS:85019754878
SN - 1473-7175
VL - 17
SP - 661
EP - 666
JO - Expert review of neurotherapeutics
JF - Expert review of neurotherapeutics
IS - 7
ER -