Seizure Outcomes in Patients with DBS for Intractable Epilepsy
Abstract number :
3.334
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2024
Submission ID :
285
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Marley Sternberg, – Wayne State University School of Medicine, MI
Ellen Air, MD, PhD – Henry Ford Hospital
Jason Schwalb, MD – Henry Ford Hospital, MI
Gregory Barkley, MD – Henry Ford Hospital, MI
Jules Constantinou, MD, FRACP – Henry Ford Hospital, MI
Brien Smith, MD, MBA – Henry Ford Hospital
Vibhangini Wasade, MD – Henry Ford Hospital, MI
Rationale: Deep Brain Stimulation (DBS) for the treatment of intractable epilepsy in adults was approved by the FDA in 2018. We assess seizure outcomes in patients treated with DBS at our epilepsy center and we explore correlation with clinical variables of the intractable epilepsy including the duration of therapy in these patients.
Methods: Patients with intractable epilepsy who underwent Medtronic- DBS implantation between 2018 and 2023 and who continued regular follow up at our epilepsy center were identified from our database. Data collected included sex, age, epilepsy type, previous surgical epilepsy treatments, age at epilepsy diagnosis, age at DBS implantation, location of DBS leads, and seizure outcomes. Seizure frequency reduction rates were grouped into responders ( >=50%) and super responders ( >=90%). Super responders and responders were combined into one group of Total Responders for purposes of statistical analysis. Chi-square tests and Mann-Whitney U tests were completed to assess the association of responder status with sex, age, epilepsy type, DBS lead location, previous surgical epilepsy treatments, epilepsy duration at implantation, and duration of DBS therapy.
Results: A total of 17 patients (5 Males, 12 Females) were included for analysis. At enrollment, the mean age was 37.1 years (SD=10.7) and the mean duration of epilepsy prior to DBS implantation was 24.3 years (SD=13.1). DBS lead location was anterior thalamic in 15 (88%) and centro-median in 2 (12%). Epilepsy types were multifocal epilepsy in 12 (71%) patients, temporal in 4 (24%), and symptomatic generalized in 1 (6%) patient. Prior surgical therapies for epilepsy included Vagus Nerve Stimulation (VNS) in 9 (53%) patients, both VNS and focal brain resection in 4 (24%), and focal resection in 1 (6%) patient. The mean follow-up after DBS implantation was 36 months (SD=20.4, range 6 to 64 months). Seizure outcomes with most recently available data indicated 9 (53%) as responders and 1 (6%) super responder, and a total DBS responder rate of 10 (59%). The super responder patient (with >=90% seizure reduction rate) had a follow up of 64 months. Total Responder status was not associated with sex, age, epilepsy type, prior epilepsy surgical treatments, DBS lead location, epilepsy duration at time of implantation or duration of DBS therapy.
Conclusions: The study findings show seizure outcomes with 50% or greater seizure reduction in 59% patients with DBS therapy at a mean follow up of 36 months, resembling those reported in the SANTE trial and by other single centers. There appears to be no association between the responder status and sex, age, epilepsy type, lead location, prior epilepsy surgical treatment, epilepsy duration prior to DBS implantation, or duration of DBS therapy in our patient population.
Funding: none
Clinical Epilepsy