Low frequency electrical stimulation through subdural electrodes in a case of refractory status epilepticus. |
| |
Authors: | Lara M Schrader John M Stern Charles L Wilson Tony A Fields Noriko Salamon Marc R Nuwer Paul M Vespa Itzhak Fried |
| |
Institution: | Department of Neurology, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Room 1-194, Los Angeles, CA 90095, USA. lschrader@mednet.ucla.edu |
| |
Abstract: | OBJECTIVE: We delivered low frequency stimulation through subdural electrodes to suppress seizures in a case of refractory status epilepticus (RSE). METHODS: A 26-year-old female developed RSE after several days of febrile illness. Seizure control required continuous infusion of two anesthetics plus high doses of 2-4 enteral antiepileptic drugs. After 3 months of RSE, subdural strips were placed to determine surgical candidacy. Five independent ictal onset zones were identified. Because she was a poor candidate for epilepsy surgery and had a poor prognosis, the implanted subdural electrodes were used to administer 0.5 Hz stimulations to the ictal onset zones in 30 min trains daily for 7 consecutive days in an attempt to suppress seizures. RESULTS: After 1 day of stimulation, one anesthetic agent was successfully discontinued. Seizures only returned by the 4th day when the second anesthetic had been reduced by 60%. Upon returning, seizures arose from only one of the 5 original ictal onset zones. Unfortunately, RSE persisted, and she eventually died. CONCLUSIONS: In this case of RSE, low frequency stimulation through subdural electrodes transiently suppressed seizures from all but one ictal onset zone and allowed significant reduction in seizure medication. SIGNIFICANCE: Low frequency cortical stimulation may be useful in suppressing seizures. |
| |
Keywords: | |
|
|