Network Basis of Seizures Induced by Deep Brain Stimulation: Literature Review and Connectivity Analysis.
Anorexia Nervosa
/ therapy
Anticonvulsants
/ therapeutic use
Brain
/ diagnostic imaging
Deep Brain Stimulation
/ adverse effects
Female
Gyrus Cinguli
/ diagnostic imaging
Hippocampus
/ diagnostic imaging
Humans
Lamotrigine
/ therapeutic use
Magnetic Resonance Imaging
Middle Aged
Neural Pathways
/ diagnostic imaging
Seizures
/ diagnostic imaging
Temporal Lobe
/ diagnostic imaging
Deep brain stimulation
Epilepsy
Functional connectivity
Functional neurosurgery
Magnetic resonance imaging
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
08
07
2019
revised:
12
08
2019
accepted:
14
08
2019
pubmed:
27
8
2019
medline:
29
1
2020
entrez:
27
8
2019
Statut:
ppublish
Résumé
Whereas transient, self-limiting seizures are an infrequent but known complication of deep brain stimulation (DBS) implantation surgery, stimulation itself has occasionally been reported to result in seizure activity at delayed time points. The neural circuitry implicated in stimulation-induced seizures is unknown. A 47-year-old woman underwent chronic subcallosal cingulate DBS for treatment of refractory anorexia nervosa and experienced seizure with stimulation onset. Supratherapeutic voltage caused a generalized seizure. The patient subsequently experienced a full recovery. We reviewed the literature for other cases of delayed postoperative DBS seizures associated with stimulation. We also investigated whether the higher voltage may have recruited networks implicated in epilepsy. The supratherapeutic voltage stimulated a larger area and engaged vulnerable networks, including bilateral hippocampi, cingulate gyrus, and temporal lobes. Literature review identified 20 studies reporting delayed seizure after DBS surgery, 13 of which demonstrated a robust association with mostly nonmotor DBS stimulation. Nonmotor DBS targets, particularly in patients with epilepsy, may be more vulnerable to stimulation-induced seizures; as such, extra caution should be used when programming stimulation parameters at these DBS targets.
Sections du résumé
BACKGROUND
BACKGROUND
Whereas transient, self-limiting seizures are an infrequent but known complication of deep brain stimulation (DBS) implantation surgery, stimulation itself has occasionally been reported to result in seizure activity at delayed time points. The neural circuitry implicated in stimulation-induced seizures is unknown.
CASE DESCRIPTION
METHODS
A 47-year-old woman underwent chronic subcallosal cingulate DBS for treatment of refractory anorexia nervosa and experienced seizure with stimulation onset. Supratherapeutic voltage caused a generalized seizure. The patient subsequently experienced a full recovery. We reviewed the literature for other cases of delayed postoperative DBS seizures associated with stimulation. We also investigated whether the higher voltage may have recruited networks implicated in epilepsy. The supratherapeutic voltage stimulated a larger area and engaged vulnerable networks, including bilateral hippocampi, cingulate gyrus, and temporal lobes. Literature review identified 20 studies reporting delayed seizure after DBS surgery, 13 of which demonstrated a robust association with mostly nonmotor DBS stimulation.
CONCLUSIONS
CONCLUSIONS
Nonmotor DBS targets, particularly in patients with epilepsy, may be more vulnerable to stimulation-induced seizures; as such, extra caution should be used when programming stimulation parameters at these DBS targets.
Identifiants
pubmed: 31449994
pii: S1878-8750(19)32250-8
doi: 10.1016/j.wneu.2019.08.094
pii:
doi:
Substances chimiques
Anticonvulsants
0
Lamotrigine
U3H27498KS
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
314-320Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.