title: Deep brain stimulation in patients with refractory temporal lobe epilepsy.
abstract: OBJECTIVE
  This pilot study prospectively evaluated the efficacy of long-term deep brain stimulation (DBS) in medial temporal lobe (MTL) structures in patients with MTL epilepsy.
  
  
  METHODS
  Twelve consecutive patients with refractory MTL epilepsy were included in this study. The protocol included invasive video-EEG monitoring for ictal-onset localization and evaluation for subsequent stimulation of the ictal-onset zone. Side effects and changes in seizure frequency were carefully monitored.
  
  
  RESULTS
  Ten of 12 patients underwent long-term MTL DBS. Two of 12 patients underwent selective amygdalohippocampectomy. After mean follow-up of 31 months (range, 12-52 months), one of 10 stimulated patients are seizure free (>1 year), one of 10 patients had a >90% reduction in seizure frequency; five of 10 patients had a seizure-frequency reduction of > or =50%; two of 10 patients had a seizure-frequency reduction of 30-49%; and one of 10 patients was a nonresponder. None of the patients reported side effects. In one patient, MRI showed asymptomatic intracranial hemorrhages along the trajectory of the DBS electrodes. None of the patients showed changes in clinical neurological testing. Patients who underwent selective amygdalohippocampectomy are seizure-free (>1 year), AEDs are unchanged, and no side effects have occurred.
  
  
  CONCLUSIONS
  This open pilot study demonstrates the potential efficacy of long-term DBS in MTL structures that should now be further confirmed by multicenter randomized controlled trials.
authors.affiliation: Reference Center for Refractory Epilepsy, Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. Paul.Boon@UGent.be
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.forename: Veerle
authors.initials: V
authors.lastname: De Herdt
authors.forename: Annelies
authors.initials: A
authors.lastname: Van Dycke
authors.forename: Maarten
authors.initials: M
authors.lastname: Goethals
authors.forename: Lut
authors.initials: L
authors.lastname: Goossens
authors.forename: Michel
authors.initials: M
authors.lastname: Van Zandijcke
authors.forename: Tim
authors.initials: T
authors.lastname: De Smedt
authors.forename: Isabelle
authors.initials: I
authors.lastname: Dewaele
authors.forename: Rik
authors.initials: R
authors.lastname: Achten
authors.forename: Wytse
authors.initials: W
authors.lastname: Wadman
authors.forename: Frank
authors.initials: F
authors.lastname: Dewaele
authors.forename: Jacques
authors.initials: J
authors.lastname: Caemaert
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Roost
mesh_terms: D000679:Amygdala / Q000601:surgery; D000927:Anticonvulsants / Q000627:therapeutic use; D001931:Brain Mapping; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology; D046690:Deep Brain Stimulation / Q000379:methods*; D018572:Disease-Free Survival; D004567:Electrodes, Implanted / Q000009:adverse effects; D004569:Electroencephalography / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008991:Monitoring, Physiologic; D010865:Pilot Projects; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants