Stim 100-185 Hz, 130 Hz, 450 µs, 2-3 v 130 Hz, 300µs, 2v parameters µs, 1-10v Sz free 2 Initially worsened, 87-95% 6 100 % RR Outcome no clear diff in on 50-80% 3 Av 78% and off <50% 1 Improvement related to Improved alertness Neuropsych N/A outcome Sz Outcome (SNAP IV) Anterolateral nucleus in Improvement in Comments parvocellular best alertness at 0.5v and response sz control at 1.5 v patients selected from population undergoing invasive electrodes: diagnostic electrodes replaced with stimulation electrodes at site of seizure focus. 25-100% response rates (50% reduction in seizures; some become seizure free). causes no change in neuropsychological Stim Seizure Study n Randomization Comment Outcome 130 Hz Absence of MS on Velasco et al Immediate on 100% RR No 9 450 us MRI predicts Epilepsia vs 1 mo 4/9 sz free decline ‘07 cyclic success 130 Hz 70% RR Pts selected based Boon et al No 10 no 450 us 1/10 sz free on dec in spikes Epilepsia decline ’07 cont (+MS) with stim Alternating 1 190 Hz Design of Telez-Zellento 25% RR No 4 mo blocks over 90 us randomiz not ¼ sz free decline et al Neurol ‘06 6 mo cont optimal STN Author N Localization of epilepsy Outcome 3 sensory cortex 67-87% Benabid/Chabardes 2 < 50% 2002 1 0 Shon (Seoul) 2 FLE s/p failed resection 87-89% Stereotact Neurosurg 2005;83:84–90
Stim parameters 130 Hz, 450 µs, 2-3 v 130 Hz, 300µs, 2v 100-185 Hz, µs, 1-10v Outcome Sz free 2 87-95% 6 50-80% 3 <50% 1 100 % RR Av 78% Initially worsened, no clear diff in on and off Neuropsych outcome Improvement related to Sz Outcome Improved alertness (SNAP IV) N/A Comments Anterolateral nucleus in parvocellular best response Improvement in alertness at 0.5v and sz control at 1.5 v patients selected from population undergoing invasive electrodes: diagnostic electrodes replaced with stimulation electrodes at site of seizure focus. 25-100% response rates (50% reduction in seizures; some become seizure free). causes no change in neuropsychological Study n Randomization Stim Seizure Outcome Comment Velasco et al Epilepsia ‘07 9 Immediate on vs 1 mo 130 Hz 450 us cyclic 100% RR 4/9 sz free No decline Absence of MS on MRI predicts success Boon et al Epilepsia ’07 10 no 130 Hz 450 us cont 70% RR 1/10 sz free (+MS) No decline Pts selected based on dec in spikes with stim Telez-Zellento et al Neurol ‘06 4 Alternating 1 mo blocks over 6 mo 190 Hz 90 us cont 25% RR ¼ sz free No decline Design of randomiz not optimal STN Author N Localization of epilepsy Outcome Benabid/Chabardes 2002 3 sensory cortex 67-87% 2 < 50% 1 0 Shon (Seoul) Stereotact Neurosurg 2005;83:84–90 2 FLE s/p failed resection 87-89%
E11.%20Epilepsy%20-%20Surgical%20Treatment.docx