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Clin Neurophysiol. 2006 Apr;117(4):781-8. Epub 2006 Feb 2.

Low frequency electrical stimulation through subdural electrodes in a case of refractory status epilepticus.

Author information

1
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.

PMID:
16458067
DOI:
10.1016/j.clinph.2005.12.010
[Indexed for MEDLINE]

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