Continuous Electrical Brain Stimulation Could be a Treatment Option for People with Drug-Resistant Epilepsy
Continuous electrical brain stimulation could help to suppress epileptic seizures, offering a new treatment option for people who have epilepsy that cannot be treated with surgery or medication. These findings are published in JAMA Neurology,
First Author Dr Brian Lundstrom, at Mayo Clinic in Rochester, US, said: “We think this approach not only provides an effective treatment for those with focal epilepsy, but will allow us to develop ways of assessing seizure likelihood for all epilepsy patients. It would be of enormous clinical benefit if we could personalise treatment regimens for individual patients without waiting for seizures to happen.”
Doctors have attempted to suppress seizures by electrically stimulating the focus, or area in the brain where they originate. However, this approach rarely stopped seizures altogether.
In the present study, researchers found that electrical brain stimulation that couldn’t be felt by the patient was able to suppress electrical discharges that occur intermittently during normal brain function. It was also able to reduce the frequency and, in some cases, the intensity and duration of seizures.
Dr Lundstrom and colleagues conducted their study on 13 people with drug-resistant epilepsy who were also not eligible for surgery. They placed a grid of electrical contacts on their brains and sent stimulation at levels unnoticeable by the participants. In people for whom the electrical stimulation provided clinical benefits, the researchers replaced the temporary grid with a more permanent one that could offer continuous stimulation.
They found that 10 of the 13 patients (77%) reported improvement in both the severity of the epilepsy and their life satisfaction. The majority experienced more than a 50% reduction in seizures, and 44% were free of disabling seizures.
Epileptic seizures can be controlled with drugs in approximately two third of cases. However, one third of people with epilepsy have drug-resistant epilepsy. A proportion of these patients may be eligible for surgery where the focus, or portion of the brain in which seizures arise, is removed. Sometimes the focus is situated in an area of the brain that controls speech, language, vision, sensation or movement. In these cases surgery cannot be performed and electrical brain stimulation may be the only option.
Dr Lundstrom said that the risks associated with this approach are relatively minimal and include the risk of infection, bleeding and the stimulation being noticed by the patient.
According to the authors, further studies are needed to measure the exact effects of this treatment and examine the mechanism by which it suppresses seizures. They hope to examine the efficacy of this approach in more depth in the near future.
Author: Dr Özge Özkaya
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