Seizure Outcome After Battery Depletion in Epileptic Patients Submitted to Deep Brain Stimulation.
OBJECTIVE
We studied patients treated with chronic DBS in whom there was depletion of the generator's battery, in order to get insight on the modulatory potential of chronic DBS in refractory epilepsy.


METHODS
Nine adult patients with refractory epilepsy treated with at least three years of deep brain stimulation (DBS), and who were followed up for at least six months after battery depletion were studied. One patient was treated with hippocampal DBS (Hip-DBS), two to centro-median DBS (CM-DBS) and six to anterior nucleus stimulation (AN-DBS).


RESULTS
Two patients did not have seizure's frequency modification after battery depletion; the other seven patients had seizure frequency increase, including those three patients that were seizure-free. Five of those seven patients who had seizure frequency increase after battery's depletion had seizure's frequency lower than their pre-DBS baseline seizure frequency; two of such patients returned to their pre-DBS baseline seizure frequency.


CONCLUSIONS
In the majority of the patients, three years of chronic DBS did not show a permanent effect on epileptogenesis. On the other hand, the post-battery depletion seizure's frequency was usually much lower than the baseline (pre-DBS) seizure's frequency, suggesting that there was actual network neuromodulation.
Clinica de Epilepsia de Sao Paulo, Sao Paulo, SP, Brazil.|Faculdade de Medicina do ABC, Sto Andre, SP, Brazil.
Arthur
A
Cukiert
Clinica de Epilepsia de Sao Paulo, Sao Paulo, SP, Brazil.|Faculdade de Medicina do ABC, Sto Andre, SP, Brazil.
Cristine Mella
CM
Cukiert
Clinica de Epilepsia de Sao Paulo, Sao Paulo, SP, Brazil.|Hospital Brigadeiro, São Paulo, SP, Brazil.
Jose Augusto
JA
Burattini
Hospital Brigadeiro, São Paulo, SP, Brazil.
Alessandra de Moura
Ade M
Lima
D020643:Anterior Thalamic Nuclei / Q000502:physiology; D000927:Anticonvulsants / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000379:methods*; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006624:Hippocampus / Q000502:physiology; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D016896:Treatment Outcome
D000927:Anticonvulsants
DBS; epilepsy; outcome; seizures