Chapter

Vagal Nerve Stimulation and Deep Brain Stimulation in Epilepsy

Paul A. J. M. Boon and Kristl E. Vonck

in Oxford Textbook of Epilepsy and Epileptic Seizures

Published on behalf of Oxford University Press

Published in print December 2012 | ISBN: 9780199659043
Published online December 2012 | e-ISBN: 9780191751363 | DOI: http://dx.doi.org/10.1093/med/9780199659043.003.0030

Series: Oxford Textbook of

Vagal Nerve Stimulation and Deep Brain Stimulation in Epilepsy

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Neurostimulation is emerging as a medical treatment for resistant neuropsychiatric disorders. Currently about 30% of patients with epilepsy are not seizure-free with the available pharmacological and surgical treatments. Vagus nerve stimulation (VNS) is indicated in patients with refractory epilepsy who are unsuitable candidates for epilepsy surgery or who have had insufficient benefit from such a treatment. VNS has become a valuable treatment option for patients with refractory epilepsy and it is currently routinely available in epilepsy centers worldwide. Deep brain stimulation (DBS) is a relatively more recently explored treatment modality in epilepsy. Compared to VNS it is a more invasive treatment option.Clinical trials with DBS in various intracerebral structures such as the thalamus, the subthalamic nucleus, the caudate nucleus and medial temporal lobe structures have been performed. Cortical stimulation (CS) in a closed loop system (Responsive neurostimulator system, RNS) is currently being investigated in a multicenter trial. It seems likely that neurostimulation for epilepsy will become a more practical and more frequently used treatment modality for patients with refractory epilepsy.

Chapter.  8847 words.  Illustrated.

Subjects: Neurology

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