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Chapter 23 - Stimulation Therapies for Epilepsy

Published online by Cambridge University Press:  11 October 2019

Vibhangini S. Wasade
Affiliation:
Henry Ford Medical Group HFHS, Michigan
Marianna V. Spanaki
Affiliation:
Wayne State University, Michigan
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Summary

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.

Type
Chapter
Information
Understanding Epilepsy
A Study Guide for the Boards
, pp. 432 - 441
Publisher: Cambridge University Press
Print publication year: 2019

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References

Kwan, P, Brodie, MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314319.CrossRefGoogle ScholarPubMed
Jobst, BC, Cascino, GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA. 2015;313(3):285293.CrossRefGoogle ScholarPubMed
Engel, J Jr., Wiebe, S, French, J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy. Report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology. 2003;60(4):538547.CrossRefGoogle ScholarPubMed
Moshe, SL, Perucca, E, Ryvlin, P, Tomson, T. Epilepsy: new advances. Lancet. 2015;385(9971):884898.CrossRefGoogle ScholarPubMed
DeGiorgio, CM, Murray, D, Markovic, D, Whitehurst, T. Trigeminal nerve stimulation for epilepsy: long-term feasibility and efficacy. Neurology. 2009;72(10):936938.CrossRefGoogle ScholarPubMed
Fisher, RS, Velasco, AL. Electrical brain stimulation for epilepsy. Nat Rev Neurol. 2014;10(5):261270.CrossRefGoogle ScholarPubMed
Chase, MH, Nakamura, Y, Clemente, CD, Sterman, MB. Afferent vagal stimulation: neurographic correlates of induced EEG synchronization and desynchronization. Brain Res. 1967;5(2):236249.CrossRefGoogle ScholarPubMed
McLachlan, RS. Suppression of interictal spikes and seizures by stimulation of the vagus nerve. Epilepsia. 1993;34(5):918923.CrossRefGoogle ScholarPubMed
Woodbury, DM, Woodbury, JW. Effects of vagal stimulation on experimentally induced seizures in rats. Epilepsia. 1990;31 Suppl 2(s2):S719.CrossRefGoogle ScholarPubMed
Zabara, J. Inhibition of experimental seizures in canines by repetitive vagal stimulation. Epilepsia. 1992;33(6):10051012.CrossRefGoogle ScholarPubMed
McLachlan, RS. Vagus nerve stimulation for intractable epilepsy: a review. J Clin Neurophysiol. 1997;14(5):358368.CrossRefGoogle ScholarPubMed
Rutecki, P. Anatomical, physiological, and theoretical basis for the antiepileptic effect of vagus nerve stimulation. Epilepsia. 1990;31 Suppl 2(s2):S1–6.CrossRefGoogle ScholarPubMed
Ko, D, Heck, C, Grafton, S, et al. Vagus nerve stimulation activates central nervous system structures in epileptic patients during PET H215O blood flow imaging. Neurosurgery. 1996;39(2):426431.CrossRefGoogle Scholar
Henry, TR, Bakay, RA, Votaw, JR, et al. Brain blood flow alterations induced by therapeutic vagus nerve stimulation in partial epilepsy: I. Acute effects at high and low levels of stimulation. Epilepsia. 1998;39(9):983990.CrossRefGoogle Scholar
Henry, TR, Votaw, JR, Pennell, PB, et al. Acute blood flow changes and efficacy of vagus nerve stimulation in partial epilepsy. Neurology. 1999;52(6):11661173.CrossRefGoogle ScholarPubMed
Vagus Nerve Stimulation Study Group. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1995;45(2):224230.CrossRef
Ben-Menachem, E, Mañon-Espaillat, R, Ristanovic, R, et al. Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. First International Vagus Nerve Stimulation Study Group. Epilepsia. 1994;35(3):616626.CrossRefGoogle ScholarPubMed
Handforth, A, DeGiorgio, CM, Schachter, SC, et al. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology. 1998;51(1):4855.CrossRefGoogle ScholarPubMed
Elliott, RE, Morsi, A, Tanweer, O, et al. Efficacy of vagus nerve stimulation over time: review of 65 consecutive patients with treatment-resistant epilepsy treated with VNS > 10 years. Epilepsy Behav. 2011;20(3):478483.CrossRefGoogle ScholarPubMed
DeGiorgio, CM, Schachter, SC, Handforth, A, et al. Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures. Epilepsia. 2000;41(9):11951200.CrossRefGoogle ScholarPubMed
Kuba, R, Brazdil, M, Kalina, M, et al. Vagus nerve stimulation: longitudinal follow-up of patients treated for 5 years. Seizure. 2009;18(4):269274.CrossRefGoogle ScholarPubMed
Eggleston, KS, Olin, BD, Fisher, RS. Ictal tachycardia: the head-heart connection. Seizure. 2014;23(7):496505.CrossRefGoogle ScholarPubMed
Fisher, RS, Afra, P, Macken, M, et al. Automatic vagus nerve stimulation triggered by ictal tachycardia: clinical outcomes and device performance – the U.S. E-37 Trial. Neuromodulation. 2016;19(2):188195.CrossRefGoogle ScholarPubMed
Kostov, H, Larsson, PG, Roste, GK. Is vagus nerve stimulation a treatment option for patients with drug-resistant idiopathic generalized epilepsy? Acta Neurol Scand Suppl. 2007;187(s187):5558.CrossRefGoogle ScholarPubMed
Morris, GL, 3rd, Gloss, D, Buchhalter, J, et al. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy. Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;81(16):14531459.CrossRefGoogle ScholarPubMed
Shahwan, A, Bailey, C, Maxiner, W, Harvey, AS. Vagus nerve stimulation for refractory epilepsy in children: more to VNS than seizure frequency reduction. Epilepsia. 2009;50(5):12201228.CrossRefGoogle ScholarPubMed
Zamponi, N, Passamonti, C, Cesaroni, E, Trignani, R, Rychlicki, F. Effectiveness of vagal nerve stimulation (VNS) in patients with drop-attacks and different epileptic syndromes. Seizure. 2011;20(6):468474.CrossRefGoogle ScholarPubMed
Boon, P, D’Have, M, Van Walleghem, P, et al. Direct medical costs of refractory epilepsy incurred by three different treatment modalities: a prospective assessment. Epilepsia. 2002;43(1):96102.CrossRefGoogle ScholarPubMed
Helmers, SL, Duh, MS, Guerin, A, et al. Clinical outcomes, quality of life, and costs associated with implantation of vagus nerve stimulation therapy in pediatric patients with drug-resistant epilepsy. Eur J Paediatr Neurol. 2012;16(5):449458.CrossRefGoogle ScholarPubMed
Penfield, W, Jasper, H. Epilepsy and the Functional Anatomy of the Human Brain. Boston, MA: Little, Brown; 1954.CrossRefGoogle Scholar
D’Arcangelo, G, Panuccio, G, Tancredi, V, Avoli, M. Repetitive low-frequency stimulation reduces epileptiform synchronization in limbic neuronal networks. Neurobiol Dis. 2005;19(1–2):119128.CrossRefGoogle Scholar
Liang, F, Isackson, PJ, Jones, EG. Stimulus-dependent, reciprocal up- and downregulation of glutamic acid decarboxylase and Ca2+/calmodulin-dependent protein kinase II gene expression in rat cerebral cortex. Exp Brain Res. 1996;110(2):163174.CrossRefGoogle ScholarPubMed
Thompson, SM, Gahwiler, BH. Activity-dependent disinhibition. I. Repetitive stimulation reduces IPSP driving force and conductance in the hippocampus in vitro. J Neurophysiol. 1989;61(3):501511.CrossRefGoogle ScholarPubMed
Thompson, SM, Gahwiler, BH. Activity-dependent disinhibition. III. Desensitization and GABAB receptor-mediated presynaptic inhibition in the hippocampus in vitro. J Neurophysiol. 1989;61(3):524533.CrossRefGoogle ScholarPubMed
Toprani, S, Durand, DM. Long-lasting hyperpolarization underlies seizure reduction by low frequency deep brain electrical stimulation. J Physiol. 2013;591(22):57655790.CrossRefGoogle ScholarPubMed
Feng, Z, Zheng, X, Yu, Y, Durand, DM. Functional disconnection of axonal fibers generated by high frequency stimulation in the hippocampal CA1 region in-vivo. Brain Res. 2013;1509:3242.CrossRefGoogle ScholarPubMed
Stone, SS, Teixeira, CM, Devito, LM, et al. Stimulation of entorhinal cortex promotes adult neurogenesis and facilitates spatial memory. J Neurosci. 2011;31(38):1346913484.CrossRefGoogle ScholarPubMed
McCreery, DB, Agnew, WF, Yuen, TGH, Bullara, L. Charge density and charge per phase as cofactors in neural injury induced by electrical stimulation. IEEE Trans Biomed Eng. 1990;37(10):9961001.CrossRefGoogle ScholarPubMed
RNS System in Epilepsy Study Group: Morrell, MJ. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology. 2011;77(13):12951304.CrossRefGoogle ScholarPubMed
Wong, CH, Birkett, J, Byth, K, et al. Risk factors for complications during intracranial electrode recording in presurgical evaluation of drug resistant partial epilepsy. Acta Neurochir (Wien). 2009;151(1):3750.CrossRefGoogle ScholarPubMed
Weaver, FM, Follett, K, Stern, M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):6373.CrossRefGoogle ScholarPubMed
Heck, CN, King-Stephens, D, Massey, AD, et al. Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS System Pivotal trial. Epilepsia. 2014;55(3):432441.CrossRefGoogle ScholarPubMed
Bergey, GK, Morrell, MJ, Mizrahi, EM, et al. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology. 2015;84(8):810817.CrossRefGoogle ScholarPubMed
Jobst, BC, Kapur, R, Barkley, GL, et al. Brain-responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia. 2017;58(6):10051014.CrossRefGoogle ScholarPubMed
Geller, EB, Skarpaas, TL, Gross, RE, et al. Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia. 2017;58(6):9941004.CrossRefGoogle ScholarPubMed
Loring, DW, Kapur, R, Meador, KJ, Morrell, MJ. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia. 2015;56(11):18361844.CrossRefGoogle ScholarPubMed
RNS® System Pivotal Trial Investigators: Meador, KJ, Kapur, R, Loring, DW, Kanner, AM, Morrell, MJ. Quality of life and mood in patients with medically intractable epilepsy treated with targeted responsive neurostimulation. Epilepsy Behav. 2015;45:242247.CrossRefGoogle ScholarPubMed
King-Stephens, D, Mirro, E, Weber, PB, et al. Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. Epilepsia. 2015;56(6):959967.CrossRefGoogle ScholarPubMed
Spencer, DC, Sun, FT, Brown, SN, et al. Circadian and ultradian patterns of epileptiform discharges differ by seizure-onset location during long-term ambulatory intracranial monitoring. Epilepsia. 2016;57(9):14951502.CrossRefGoogle ScholarPubMed
Fisher, R, Salanova, V, Witt, T, et al. Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia. 2010;51(5):899908.CrossRefGoogle ScholarPubMed
Lhatoo, SD, Sander, JW. Cause-specific mortality in epilepsy. Epilepsia. 2005;46 Suppl 11(s11):3639.CrossRefGoogle ScholarPubMed
Tomson, T, Walczak, T, Sillanpaa, M, Sander, JW. Sudden unexpected death in epilepsy: a review of incidence and risk factors. Epilepsia. 2005;46 Suppl 11(s11):5461.CrossRefGoogle ScholarPubMed
Nilsson, L, Ahlbom, A, Farahmand, BY, Tomson, T. Mortality in a population-based cohort of epilepsy surgery patients. Epilepsia. 2003;44(4):575581.CrossRefGoogle Scholar
Dasheiff, RM. Sudden unexpected death in epilepsy: a series from an epilepsy surgery program and speculation on the relationship to sudden cardiac death. J Clin Neurophysiol. 1991;8(2):216222.CrossRefGoogle ScholarPubMed
Annegers, JF, Coan, SP, Hauser, WA, et al. Epilepsy, vagal nerve stimulation by the NCP system, mortality, and sudden, unexpected, unexplained death. Epilepsia. 1998;39(2):206212.CrossRefGoogle ScholarPubMed

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