Estimulación hipocampal de baja y alta frecuencia en la epilepsia del lóbulo temporal mesial fármaco resistente.: Publicado originalmente en la revista Neuromodulation 2016; 19: 365-72. Traducción: Dra. Verónica Montilla.

Siew-Na Lim; Ching-Yi Lee; Shih-Tseng Lee; Po-Hsun Tu; Bao-Luen Chang; Chih-Hong Lee; Mei-Yun Cheng; Chun-Wei Chang; Wei-En Johnny Tseng; Hsiang-Yao Hsieh; Hsing-I Chiang; Tony Wu

doi:10.47924/neurotarget2016176

Authors

Siew-Na Lim Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Ching-Yi Lee Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Shih-Tseng Lee Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Po-Hsun Tu Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Bao-Luen Chang Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chih-Hong Lee Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Mei-Yun Cheng Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chun-Wei Chang Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Wei-En Johnny Tseng Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Hsiang-Yao Hsieh Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Hsing-I Chiang Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Tony Wu Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.

DOI:

https://doi.org/10.47924/neurotarget2016176

Keywords:

Deep brain stimulation, Epilepsy, High frequency electrical stimulation, Low frequency electrical stimulation, Outcomes

Abstract

Objective: Electrical stimulation of the hippocampus offers the possibility to treat patients with mesial temporal lobe epilepsy (MTLE) who are not surgical candidates. We report long-term follow-up results in five patients receiving low or high frequency hippocampal stimulation for drug-resistant MTLE.
Materials and Methods: The patients underwent stereotactic implantation of quadripolar stimulating electrodes in the hippo- campus. Two of the patients received unilateral electrode implantation, while the other three received bilateral implantation. Stimulation of the hippocampal electrodes was turned ON immediately after the implantation of an implantable pulse generator, with initial stimulation parameters: 1 V, 90–150 ls, 5 or 145 Hz. The frequency of seizures was monitored and compared with pre- implantation baseline data.
Results: Two men and three women, aged 27–61 years were studied, with a mean follow-up period of 38.4 months (range, 30– 42 months). The baseline seizure frequency was 2.0–15.3/month. The five patients had an average 45% (range 22–72%) reduction in the frequency of seizures after hippocampal stimulation over the study period. Low frequency hippocampal stimulation decreased the frequency of seizures in two patients (by 54% and 72%, respectively). No implantation- or stimulation-related side effects were reported.
Conclusions: Electrical stimulation of the hippocampus is a minimally invasive and reversible method that can improve seizure outcomes in patients with drug-resistant MTLE. The optimal frequency of stimulation varied from patient to patient and therefore required individual setting. These experimental results warrant further controlled studies with a large patient population to evaluate the long-term effect of hippocampal stimulation with different stimulation parameters.

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