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Chapter 24 - Neurostimulation for the Treatment of Insular Epilepsy

from Section 5 - Surgical Management of Insular Epilepsy

Published online by Cambridge University Press:  09 June 2022

By
Patricia C. Dugan  and
Barbara C. Jobst
Edited by
Dang Nguyen ,
Jean Isnard  and
Philippe Kahane
Dang Nguyen
Affiliation:
Université de Montréal
Jean Isnard
Affiliation:
Claude Bernard University Lyon
Philippe Kahane
Affiliation:
Grenoble-Alpes University Hospital
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Summary

The surgical treatment of refractory insular epilepsy is challenging because of its deep-seated anatomical location, the rich vasculature within this region, and its connectivity with highly eloquent brain regions. Neurostimulation is a burgeoning complementary treatment for drug-resistant epilepsy patients who may not be candidates for surgical resection. There is Class I evidence supporting the efficacy and safety of responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS) of the anterior nucleus of the thalamus. All of these modalities have comparable efficacy, as demonstrated in their respective pivotal trials and subsequent longer-term trials. There is, however, a paucity of published data at this time describing their use specifically for the treatment of refractory extratemporal epilepsy or insular epilepsy in particular.

Keywords

surgeryneurostimulationvagus nerve stimulationresponsive neurostimulationdeep brain stimulation
Type
Chapter
Information
Insular Epilepsies , pp. 278 - 286
Publisher: Cambridge University Press
Print publication year: 2022

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References

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