Journal article
Deep Brain Stimulation of Bilateral Centromedian Thalamic Nuclei in Pediatric Patients with Lennox-Gastaut Syndrome: An Institutional Experience
World neurosurgery, Vol.185, pp.e631-e639
05/2024
DOI: 10.1016/j.wneu.2024.02.099
PMID: 38403017
Abstract
Surgical management of pediatric patients with nonlesional, drug-resistant epilepsy, including patients with Lennox-Gastaut syndrome (LGS), remains a challenge given the lack of resective targets in most patients and shows seizure freedom rates <50% at 5 years. The efficacy of deep brain stimulation (DBS) is less certain in children than in adults. This study examined clinical and seizure outcomes for pediatric patients with LGS undergoing DBS targeting of the centromedian thalamic nuclei (CMTN).
An institutional review board–approved retrospective analysis was performed of patients aged ≤19 years with clinical diagnosis of LGS undergoing bilateral DBS placement to the CMTN from 2020 to 2021 by a single surgeon.
Four females and 2 males aged 6–19 years were identified. Before surgery, each child experienced at least 6 years of refractory seizures; 4 children had experienced seizures since infancy. All took antiseizure medications at the time of surgery. Five children had previous placement of a vagus nerve stimulator and 2 had a previous corpus callosotomy. The mean length of stay after DBS was 2 days. No children experienced adverse neurologic effects from implantation; the mean follow-up time was 16.3 months. Four patients had >60% reduction in seizure frequency after surgery, 1 patient experienced 10% reduction, and 1 patient showed no change. No children reported worsening seizure symptoms after surgery.
Our study contributes to the sparse literature describing CMTN DBS for children with drug-resistant epilepsy from LGS. Our results suggest that CMTN DBS is a safe and effective therapeutic modality that should be considered as an alternative or adjuvant therapy for this challenging patient population. Further studies with larger patient populations are warranted.
Details
- Title: Subtitle
- Deep Brain Stimulation of Bilateral Centromedian Thalamic Nuclei in Pediatric Patients with Lennox-Gastaut Syndrome: An Institutional Experience
- Creators
- David Bonda - University of WashingtonKatherine A. Kelly - University of WashingtonScott Boop - University of WashingtonAbdullah H. Feroze - University of WashingtonStephanie C. Randle - University of WashingtonMike Bindschadler - Seattle Children's HospitalAhmad Marashly - University of WashingtonJames Owens - University of IowaJason Lockrow - University of WashingtonXiuhua Bozarth - University of WashingtonEdward Novotny - University of WashingtonSeth Friedman - Seattle Children's HospitalHannah E. Goldstein - University of WashingtonBenjamin L. Grannan - University of WashingtonSharon Durfy - University of WashingtonJeffrey G. Ojemann - University of WashingtonAndrew L. Ko - University of WashingtonJason S. Hauptman - University of Washington
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.185, pp.e631-e639
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.wneu.2024.02.099
- PMID
- 38403017
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Stead Family Department of Pediatrics; Neurology (Pediatrics)
- Record Identifier
- 9984701742802771
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