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Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature

There is a paucity of treatment options for cognitively normal individuals with drug resistant genetic generalized epilepsy (GGE). Centromedian nucleus of the thalamus (CM) deep brain stimulation (DBS) may be a viable treatment for GGE. Here, we present the case of a 27-year-old cognitively normal w...

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Autores principales: Agashe, Shruti, Burkholder, David, Starnes, Keith, Van Gompel, Jamie J., Lundstrom, Brian N., Worrell, Gregory A., Gregg, Nicholas M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164300/
https://www.ncbi.nlm.nih.gov/pubmed/35669200
http://dx.doi.org/10.3389/fnhum.2022.858413
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author Agashe, Shruti
Burkholder, David
Starnes, Keith
Van Gompel, Jamie J.
Lundstrom, Brian N.
Worrell, Gregory A.
Gregg, Nicholas M.
author_facet Agashe, Shruti
Burkholder, David
Starnes, Keith
Van Gompel, Jamie J.
Lundstrom, Brian N.
Worrell, Gregory A.
Gregg, Nicholas M.
author_sort Agashe, Shruti
collection PubMed
description There is a paucity of treatment options for cognitively normal individuals with drug resistant genetic generalized epilepsy (GGE). Centromedian nucleus of the thalamus (CM) deep brain stimulation (DBS) may be a viable treatment for GGE. Here, we present the case of a 27-year-old cognitively normal woman with drug resistant GGE, with childhood onset. Seizure semiology are absence seizures and generalized onset tonic clonic (GTC) seizures. At baseline she had 4–8 GTC seizures per month and weekly absence seizures despite three antiseizure medications and vagus nerve stimulation. A multidisciplinary committee recommended off-label use of CM DBS in this patient. Over 12-months of CM DBS she had two GTC seizure days, which were in the setting of medication withdrawal and illness, and no GTC seizures in the last 6 months. There was no significant change in the burden of absence seizures. Presently, just two studies clearly document CM DBS in cognitively normal individuals with GGE or idiopathic generalized epilepsy (IGE) [in contrast to studies of cognitively impaired individuals with developmental and epileptic encephalopathies (DEE)]. Our results suggest that CM DBS can be an effective treatment for cognitively normal individuals with GGE and underscore the need for prospective studies of CM DBS.
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spelling pubmed-91643002022-06-05 Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature Agashe, Shruti Burkholder, David Starnes, Keith Van Gompel, Jamie J. Lundstrom, Brian N. Worrell, Gregory A. Gregg, Nicholas M. Front Hum Neurosci Neuroscience There is a paucity of treatment options for cognitively normal individuals with drug resistant genetic generalized epilepsy (GGE). Centromedian nucleus of the thalamus (CM) deep brain stimulation (DBS) may be a viable treatment for GGE. Here, we present the case of a 27-year-old cognitively normal woman with drug resistant GGE, with childhood onset. Seizure semiology are absence seizures and generalized onset tonic clonic (GTC) seizures. At baseline she had 4–8 GTC seizures per month and weekly absence seizures despite three antiseizure medications and vagus nerve stimulation. A multidisciplinary committee recommended off-label use of CM DBS in this patient. Over 12-months of CM DBS she had two GTC seizure days, which were in the setting of medication withdrawal and illness, and no GTC seizures in the last 6 months. There was no significant change in the burden of absence seizures. Presently, just two studies clearly document CM DBS in cognitively normal individuals with GGE or idiopathic generalized epilepsy (IGE) [in contrast to studies of cognitively impaired individuals with developmental and epileptic encephalopathies (DEE)]. Our results suggest that CM DBS can be an effective treatment for cognitively normal individuals with GGE and underscore the need for prospective studies of CM DBS. Frontiers Media S.A. 2022-05-20 /pmc/articles/PMC9164300/ /pubmed/35669200 http://dx.doi.org/10.3389/fnhum.2022.858413 Text en Copyright © 2022 Agashe, Burkholder, Starnes, Van Gompel, Lundstrom, Worrell and Gregg. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Agashe, Shruti
Burkholder, David
Starnes, Keith
Van Gompel, Jamie J.
Lundstrom, Brian N.
Worrell, Gregory A.
Gregg, Nicholas M.
Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title_full Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title_fullStr Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title_full_unstemmed Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title_short Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature
title_sort centromedian nucleus of the thalamus deep brain stimulation for genetic generalized epilepsy: a case report and review of literature
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164300/
https://www.ncbi.nlm.nih.gov/pubmed/35669200
http://dx.doi.org/10.3389/fnhum.2022.858413
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