Abstracts

Rationale: Neurostimulation is an important treatment option for patients with refractory focal epilepsy for whom resective surgery is not recommended or desired. Deep brain stimulation (DBS) is the newest FDA-approved neurostimulation device for epilepsy treatment since 2018, targeting the bilateral anterior nucleus of the thalamus with chronic intermittent stimulation based on the multicenter randomized controlled SANTE trial. Our study reviewed the safety and efficacy outcomes of the first nine patients at OHSU to receive DBS stimulation therapy for epilepsy.

Methods: Retrospective chart review was performed on the first nine patients at OHSU who received DBS devices for epilepsy and have gotten active stimulation for at least once year. Data were uploaded to a secure database, and descriptive statistics were performed via Excel software.

Results: The average seizure reduction was 65.83% at one year. If we exclude the patient who received concurrent surgeries of DBS and laser ablation, the average reduction was 61.56%. Three patients have had DBS therapy for two years, and the average seizure reduction for these three patients at year two was 79.17%. There were no serious adverse events associated with surgery or stimulation. Two patients had seizures during the perioperative period, but this was not out of the ordinary for their baseline seizure frequencies. One patient reported worsening of baseline depression after implant, that later improved with stimulation modifications. One patient reported itching and redness at the DBS insertion site postoperatively, which resolved. One patient reported erectile dysfunction in the year after DBS implant, but this was felt to be unrelated to stimulation.

Conclusions: Our results add to the body of evidence that DBS is a safe and effective treatment for refractory focal epilepsy. Seizure reduction in our study was comparable to the multicenter randomized controlled SANTE trial; 61.56% at year 1 (excluding the patient who had laser ablation as well as DBS implant) as compared to 41% in the SANTE trial. As the number of patients who receive DBS for epilepsy increase at our center and worldwide, there will be many future research opportunities to evaluate long term safety and efficacy of DBS stimulation, as well as a potential for studies comparing DBS therapy with other forms of neurostimulation for epilepsy.

Funding: Not available