Purpose

Temporal lobe epilepsy patients treated with hippocampal deep brain stimulation (Hip-DBS) have rarely been reported before. Preoperative and postoperative cognitive function is seldom analyzed.

Methods

Seven patients with drug-resistant temporal lobe epilepsy were included in this study. Bilateral Hip-DBS was performed in these patients. The stimulator was activated 1 month after the implantation. Then, the patients returned for further adjustments 4 months after the surgery and reprogramming every year. The seizure frequency, Wechsler Adult Intelligence Scale-IV, and Wechsler memory scale-IV were assessed blindly as the outcomes at each follow-up.

Results

After a mean 48-month follow-up, the mean seizure frequency significantly decreased (p = 0.011, paired t test; decrease of 78.1%). One patient (14.3%) was seizure-free by the last follow-up; six of seven (85.7%) patients had reductions in seizure frequency of at least 50%; one patient (14.3%) who did not comply with the antiepileptic drug instructions had a less than 50% reduction in seizure frequency. In addition, there were no significant decreases in intelligence or verbal and visual memory from baseline to the last follow-up (p = 0.736, paired t test; p = 0.380, paired t test, respectively).

Conclusion

Hip-DBS could provide acceptable long-term efficacy and safety. For patients with drug-resistant temporal lobe epilepsy who are not suitable for resective surgery, Hip-DBS could become a potential therapeutic option.

中文翻译：

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耐药性颞叶癫痫患者双侧海马深部脑刺激的长期疗效和认知作用。

目的

以前很少报道过用海马深脑刺激（Hip-DBS）治疗的颞叶癫痫患者。术前和术后的认知功能很少分析。

方法

这项研究纳入了7例耐药性颞叶癫痫患者。在这些患者中进行了双侧Hip-DBS。植入后1个月激活刺激器。然后，患者在手术后四个月返回并作进一步调整，并每年重新编程。癫痫发作频率，韦氏成人智力量表IV和韦氏记忆量表IV被盲目评估为每次随访的结果。

结果

在平均48个月的随访之后，平均癫痫发作频率显着下降（p  = 0.011，配对t检验；下降78.1％）。末次随访中无1例患者（14.3％）无癫痫发作。七名患者中有六名（85.7％）的癫痫发作频率降低了至少50％；一位不遵守抗癫痫药说明书的患者（14.3％）的癫痫发作频率降低了不到50％。此外，从基线到最后一次随访，智力或言语和视觉记忆没有显着下降（分别为p  = 0.736，配对t检验；p  = 0.380，配对t检验）。

结论

Hip-DBS可以提供​​可接受的长期疗效和安全性。对于不适合切除手术的耐药性颞叶癫痫患者，Hip-DBS可能成为潜在的治疗选择。