title: A decade of experience with deep brain stimulation for patients with refractory medial temporal lobe epilepsy.
abstract: In this study, we present long-term results from patients with medial temporal lobe (MTL) epilepsy treated with deep brain stimulation (DBS). Since 2001, 11 patients (8M) with refractory MTL epilepsy underwent MTL DBS. When unilateral DBS failed to decrease seizures by > 90%, a switch to bilateral MTL DBS was proposed. After a mean follow-up of 8.5 years (range: 67-120 months), 6/11 patients had a ≥ 90% seizure frequency reduction with 3/6 seizure-free for > 3 years; three patients had a 40%-70% reduction and two had a < 30% reduction. In 3/5 patients switching to bilateral DBS further improved outcome. Uni- or bilateral MTL DBS did not affect neuropsychological functioning. This open study with an extended long-term follow-up demonstrates maintained efficacy of DBS for MTL epilepsy. In more than half of the patients, a seizure frequency reduction of at least 90% was reached. Bilateral MTL DBS may herald superior efficacy in unilateral MTL epilepsy.
authors.affiliation: Department of Neurology, Reference Center for Refractory Epilepsy, Gent, Belgium. Kristl.Vonck@UGent.be
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.forename: Mathieu
authors.initials: M
authors.lastname: Sprengers
authors.forename: Evelien
authors.initials: E
authors.lastname: Carrette
authors.forename: Ine
authors.initials: I
authors.lastname: Dauwe
authors.forename: Marijke
authors.initials: M
authors.lastname: Miatton
authors.forename: Alfred
authors.initials: A
authors.lastname: Meurs
authors.forename: Lut
authors.initials: L
authors.lastname: Goossens
authors.forename: Veerle
authors.initials: V
authors.lastname: DE Herdt
authors.forename: Rik
authors.initials: R
authors.lastname: Achten
authors.forename: Evert
authors.initials: E
authors.lastname: Thiery
authors.forename: Robrecht
authors.initials: R
authors.lastname: Raedt
authors.forename: Dirk
authors.initials: D
authors.lastname: VAN Roost
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000145:classification / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D012640:Seizures / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants