Placebo-controlled pilot study of centromedian thalamic stimulation in treatment of intractable seizures.

摘要: Stimulation of centromedian (CM) thalamic nuclei has been proposed as a treatment for seizures. We implanted programmable subcutaneous (s.c.) stimulators into CM bilaterally in 7 patients with intractable epilepsy to test feasibility and safety. was on or off 3-month blocks, washout period double-blind, cross-over protocol. Stimuli were delivered 90-microseconds pulses at 65 pulses/s, 1 min each 5 2 h/day, voltage set half the sensory threshold. safe well-tolerated, mean reduction tonic-clonic seizure frequency 30% respect baseline when stimulator versus decrease 8% off. There no improvement total number generalized seizures stimulation, differences not statistically significant. low intensity did alter EEG acutely, but high-intensity stimulation induced slow waves 2-3 Hz spike-waves ipsilateral frontal maximum. In an open-label follow-up segment trains continuing 24 3 6 reported least 50% frequency. side effects. This pilot project demonstrated controlled study epilepsy, further will be needed demonstrate efficacy.