Published online by Cambridge University Press: 11 October 2019
Despite the availability of more than 20 antiseizure drugs (ASDs) for the treatment of epilepsy, up to 30% of patients continue to experience disabling seizures and are classified as having medically refractory epilepsy (MRE).1 Some patients with MRE are candidates for resective surgery or other palliative interventions, such as disconnection therapies (callosotomy or subpial transections).2 Unfortunately, the majority of refractory patients are not candidates for these surgical options due to having multifocal epileptogenic foci, foci localized to an eloquent brain area or because the focus cannot be adequately localized.3,4 For some of these patients, stimulation therapy (also known as neuromodulation) is an alternative palliative treatment option. This chapter will review the different neuromodulation modalities that are available as adjunctive treatment of MRE. The impact of neuromodulation on sudden unexplained death in epilepsy (SUDEP) will be explored in the final section.
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