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Brain stimulation for epilepsy

Nature Clinical Practice Neurology volume 1, pages 64–65 (2005)Cite this article

About 0.5–1% of the world's population has epilepsy. Even when optimal antiepileptic drug (AED) therapy is available, approximately 30% of patients continue to have seizures. Resective surgery is a viable option for many patients who are 'refractory' to AED treatment; however, even if—at an optimistic estimate—50% of these patients would benefit from surgery, a large number would still need new therapeutic approaches. Factors predicting a good outcome from resective surgery include temporal lobe epilepsy, identifiable focal pathology (such as hippocampal sclerosis) on MRI; and well-localized epileptiform discharges on ictal video-electroencephalographic recordings.

The use of neural stimulation has been encouraged by its increasing application to movement disorders. Stimulation targets for epilepsy include the cerebellum, caudate nucleus, thalamus (including the centromedian, anterior and subthalamic nuclei), vagus nerve, and the epileptic focus itself.1 The last of these can be stimulated indirectly, in an attempt to influence broader neuronal circuits, or directly. Varyingly invasive techniques are available for each approach.

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Authors and Affiliations

  1. Chief of the Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, and professor of neurology at the Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    William H Theodore

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  1. William H Theodore
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Correspondence to William H Theodore.

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The author declares no competing financial interests.

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Theodore, W. Brain stimulation for epilepsy. Nat Rev Neurol 1, 64–65 (2005). https://doi.org/10.1038/ncpneuro0051

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