title: Stimulation of the bilateral anterior nuclei of the thalamus in the treatment of refractory epilepsy: two cases of subcortical band heterotopia.
abstract: Subcortical band heterotopia is a neuronal migration disorder that may cause refractory epilepsy. In these patients, resective surgery has yielded inadequate results. Deep brain stimulation of the anterior nuclei of the thalamus has been used for the treatment of refractory epilepsy with good results. We describe the first two patients with subcortical band heterotopia who were submitted to deep brain stimulation of the anterior nuclei of the thalamus, with evaluation of seizure outcome after 12 and 18 months of follow-up. At these times, both showed a >50% decrease in seizure frequency and an increase in seizure freedom. Both patients had a depressive syndrome after surgery that responded fully to anti-depressive medication in one patient and partly in the other. In both, deep brain stimulation of the anterior nuclei of the thalamus was associated with good seizure outcome. This procedure can therefore be considered in the treatment of patients with subcortical band heterotopia and refractory epilepsy. Depression may be a transient adverse event of the surgery or stimulation, however, its aetiology is probably multifactorial.
authors.affiliation: Department of Neurosciences (Neurology), Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon.
authors.forename: Ana
authors.initials: A
authors.lastname: Franco
authors.affiliation: Department of Neurosciences (Neurology), Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon,, Unit of Neuropathology, Department of Neurosciences, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte.
authors.forename: José
authors.initials: J
authors.lastname: Pimentel
authors.affiliation: Neurosurgery Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon.
authors.forename: Alexandre Rainha
authors.initials: AR
authors.lastname: Campos
authors.affiliation: Neurorradiology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon.
authors.forename: Carlos
authors.initials: C
authors.lastname: Morgado
authors.affiliation: Hospital de São Bernardo, Setúbal.
authors.forename: Sara
authors.initials: S
authors.lastname: Pinelo
authors.affiliation: Neurosurgery Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon.
authors.forename: António Gonçalves
authors.initials: AG
authors.lastname: Ferreira
authors.affiliation: Department of Neurosciences (Neurology), Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon,, EEG/Sleep Lab, Department of Neurosciences, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Bentes
mesh_terms: D020643:Anterior Thalamic Nuclei; D054221:Classical Lissencephalies and Subcortical Band Heterotopias / Q000150:complications / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D003863:Depression / Q000209:etiology; D006801:Humans; D012640:Seizures / Q000209:etiology / Q000628:therapy*
keywords: deep brain stimulation; epilepsy; migration disorder; subcortical band heterotopia