Abstracts

Rationale: Deep brain stimulation of the thalamus is an alternative surgical option for patients with refractoryepilepsy not feasible for resective surgery, or in whom surgery has failed. We report our recent, short-term efficacy of DBS on bilateral centromedian thalamic nucleus (CM DBS) in subjects with intractable generalized epilepsyorfocal epilepsy with secondary generalization. Methods: Eight patients (three men; age range, 24-47years; follow-up between 3 and 11 months) were enrolled for CM DBS in Seoul St. Mary's Hospital (two patients under Lennox-Gastaut syndrome; four with schizencephaly under frequent focal seizures with secondarily generalization; one with a large lesion of FCD in R hemisphere; a patient with cryptogenic generalized epilepsy with frequent atypical absence, hypermotor and tonic seizures). Stimulation was delivered using a continuous, high-frequency Stimulation (130Hz, 90µsec pulse width, voltage ranging from 1.5 to 3.0V). Seizure counts were monitored and compared with pre-implantation baseline. Results: Comparing to baseline,there was 72.1% mean seizure reduction in all patients. Six among them showed clinically and statistically significant improvement (> 50% seizure reduction). One patient remained seizure free from the start of CM DBS for 6 months. No adverse events could clearly be attributed to stimulation. Conclusions: Our preliminary evidence suggests that CM DBS appears to be a safe and efficacious treatment, not only in patients with refractory generalized epilepsy but focal (partial) epilepsy appearing less feasible for resective surgical management. Further controlled study with much larger population should be warranted.