Comparison of seizure control outcomes and the safety of vagus nerve, thalamic deep brain, and responsive neurostimulation: evidence from randomized controlled trials.

Rolston JD, Englot DJ, Wang DD, Shih T, Chang EF
Neurosurg Focus. 2012 32 (3): E14

PMID: 22380855 · DOI:10.3171/2012.1.FOCUS11335

Epilepsy is a devastating disease, often refractory to medication and not amenable to resective surgery. For patients whose seizures continue despite the best medical and surgical therapy, 3 stimulation-based therapies have demonstrated positive results in prospective randomized trials: vagus nerve stimulation, deep brain stimulation of the thalamic anterior nucleus, and responsive neurostimulation. All 3 neuromodulatory therapies offer significant reductions in seizure frequency for patients with partial epilepsy. A direct comparison of trial results, however, reveals important differences among outcomes and surgical risk between devices. The authors review published results from these pivotal trials and highlight important differences between the trials and devices and their application in clinical use.

MeSH Terms (18)

Adolescent Adult Anterior Thalamic Nuclei Child Deep Brain Stimulation Electrodes, Implanted Epilepsy Female Follow-Up Studies Humans Magnetic Resonance Imaging Male Middle Aged Randomized Controlled Trials as Topic Subthalamic Nucleus Treatment Outcome Vagus Nerve Stimulation Young Adult

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