title: Successful Treatment of Refractory Status Epilepticus Using Anterior Thalamic Nuclei Deep Brain Stimulation.
abstract: BACKGROUND
  Refractory status epilepticus (RSE) is considered a medical emergency in neurology and is related to high mortality. We report a successfully treated case of RSE using deep brain stimulation (DBS) at the anterior thalamic nuclei (ATN) in a 17-year-old woman.
  
  
  RESULTS
  This patient developed RSE as a result of progressive seizure activity. RSE with generalized tonic-clonic seizures was noted 2 weeks before admission. Video electroencephalography monitoring showed continuous 3-Hz generalized spike-and-wave complexes with higher amplitude over bilateral frontal. Four weeks after RSE onset, bilateral DBS of the ATN was started. This treatment was immediately followed by the disappearance of tonic-clonic seizures and spike-and-wave complexes, suggesting resolution of the RSE. Significant clinical improvement was noted 1 week after DBS implantation.
  
  
  CONCLUSIONS
  DBS at the ATN significantly improved both the electroencephalography and clinical presentation in the patient with RSE. DBS at the ATN should be considered as a possible treatment choice once a patient develops RSE.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
authors.forename: Siew-Na
authors.initials: SN
authors.lastname: Lim
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
authors.forename: Tony
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan. Electronic address: yun0710@adm.cgmh.org.tw.
authors.forename: Shih-Tseng
authors.initials: ST
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D020643:Anterior Thalamic Nuclei; D046690:Deep Brain Stimulation / Q000379:methods*; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D013226:Status Epilepticus / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Anterior thalamic nucleus; Deep brain stimulation; Refractory status epilepticus