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Research Letter |

Chronic Subthreshold Cortical Stimulation to Treat Focal Epilepsy ONLINE FIRST

Brian Nils Lundstrom, MD, PhD1; Jamie Van Gompel, MD2; Jeffrey Britton, MD1; Katherine Nickels, MD1; Nicholas Wetjen, MD2; Gregory Worrell, MD, PhD1; Matt Stead, MD, PhD1
[+] Author Affiliations
1Department of Neurology, Mayo Clinic, Rochester, Minnesota
2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
JAMA Neurol. Published online September 19, 2016. doi:10.1001/jamaneurol.2016.2857
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This study reports on 13 patients treated with continuous subthreshold electrical cortical stimulation, which suppressed interictal epileptiform discharges and improved clinical seizures.

Approximately 1 to 3 in 1000 people have drug-resistant focal epilepsy.1 Resective surgical procedures are the most effective treatments for patients with epilepsy but are not feasible when seizures originate from critical cortical areas, ie, the eloquent cortex. Despite evidence for efficacy, current approaches to focal brain stimulation rarely yield seizure-free outcomes.2 We report on 13 patients treated with continuous subthreshold electrical cortical stimulation, which led to the suppression of interictal epileptiform discharges (IEDs) and improvement in clinical seizures (ie, reduced frequency, with some experiencing reduced intensity and duration).

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Quantifying Interictal Discharges

B, The dots indicate detected interictal epileptiform discharges (IEDs). C, Each bar represents six 15-minute blocks of data from a single patient. The patients in the figure correspond to the patients in the first 6 rows of the Table. The comparison of rates was significant for each patient (P = .001; P = .003; P = .01; P < .001; P = .008; P < .001). Error bars indicate standard error. D, The comparison of the mean rates was significant (P = .002). The error bars indicate standard error.

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