title: Intracranial stimulation for children with epilepsy.
abstract: OBJECTIVE
  To evaluate the efficacy of intracranial stimulation to treat refractory epilepsy in children.
  
  
  METHODS
  This is a retrospective analysis of a pilot study on all 8 children who had intracranial electrical stimulation for the investigation and treatment of refractory epilepsy at King's College Hospital between 2014 and 2015. Five children (one with temporal lobe epilepsy and four with frontal lobe epilepsy) had subacute cortical stimulation (SCS) for a period of 20-161 h during intracranial video-telemetry. Efficacy of stimulation was evaluated by counting interictal discharges and seizures. Two children had thalamic deep brain stimulation (DBS) of the centromedian nucleus (one with idiopathic generalized epilepsy, one with presumed symptomatic generalized epilepsy), and one child on the anterior nucleus (right fronto-temporal epilepsy). The incidence of interictal discharges was evaluated visually and quantified automatically.
  
  
  RESULTS
  Among the three children with DBS, two had >60% improvement in seizure frequency and severity and one had no improvement. Among the five children with SCS, four showed improvement in seizure frequency (>50%) and one chid did not show improvement. Procedures were well tolerated by children.
  
  
  CONCLUSIONS
  Cortical and thalamic stimulation appear to be effective and well tolerated in children with refractory epilepsy. SCS can be used to identify the focus and predict the effects of resective surgery or chronic cortical stimulation. Further larger studies are necessary.
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Clinical Neurophysiology, King's College Hospital NHS Trust, London, UK. Electronic address: antonio.valentin@kcl.ac.uk.
authors.forename: Antonio
authors.initials: A
authors.lastname: Valentín
authors.affiliation: Department of Neurosurgery, King's College Hospital NHS Trust, London, UK.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Selway
authors.affiliation: Department of Neurosurgery, King's College Hospital NHS Trust, London, UK.
authors.forename: Meriem
authors.initials: M
authors.lastname: Amarouche
authors.affiliation: Department of Neurosurgery, King's College Hospital NHS Trust, London, UK.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Mundil
authors.affiliation: Department of Neurosurgery, King's College Hospital NHS Trust, London, UK.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ughratdar
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Leila
authors.initials: L
authors.lastname: Ayoubian
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Clinical Neurophysiology, Kingston Hospital NHS FT, London, UK; Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Martín-López
authors.affiliation: Department of Clinical Neurophysiology, King's College Hospital NHS Trust, London, UK.
authors.forename: Farhana
authors.initials: F
authors.lastname: Kazi
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Talib
authors.initials: T
authors.lastname: Dar
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Clinical Neurophysiology, King's College Hospital NHS Trust, London, UK; School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador.
authors.forename: Diego
authors.initials: D
authors.lastname: Jiménez-Jiménez
authors.affiliation: Department of Paediatric Neurosciences, King's College Hospital NHS Trust, London, UK; Department of Paediatric Neurology, Evelina Children's Hospital, London, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Hughes
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Clinical Neurophysiology, King's College Hospital NHS Trust, London, UK; Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, Spain; Comprehensive Epilepsy Center, Neuroscience Institute, Academic Health Systems Hamad Medical Corporation, Doha, Qatar.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Alarcón
mesh_terms: D000293:Adolescent; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D046690:Deep Brain Stimulation / Q000379:methods*; D017034:Epilepsy, Frontal Lobe / Q000503:physiopathology / Q000534:rehabilitation*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012189:Retrospective Studies; D013788:Thalamus / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Cortical stimulation; DBS; Deep brain stimulation; Epilepsy; Intracerebral; Neuromodulation; Thalamus