Journal
NEUROSURGERY
Volume 69, Issue 4, Pages 957-979Publisher
OXFORD UNIV PRESS INC
DOI: 10.1227/NEU.0b013e31822b30cd
Keywords
Brain cooling; Deep-brain stimulation; Drug delivery; Epilepsy; Gene therapy; Neuromodulation; Neurostimulation
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Neuromodulation strategies have been proposed to treat a variety of neurological disorders, including medication-resistant epilepsy. Electrical stimulation of both central and peripheral nervous systems has emerged as a possible alternative for patients who are not deemed to be good candidates for resective procedures. In addition to well-established treatments such as vagus nerve stimulation, epilepsy centers around the world are investigating the safety and efficacy of neurostimulation at different brain targets, including the hippocampus, thalamus, and subthalamic nucleus. Also promising are the preliminary results of responsive neuromodulation studies, which involve the delivery of stimulation to the brain in response to detected epileptiform or pre-epileptiform activity. In addition to electrical stimulation, novel therapeutic methods that may open new horizons in the management of epilepsy include transcranial magnetic stimulation, focal drug delivery, cellular transplantation, and gene therapy. We review the current strategies and future applications of neuromodulation in epilepsy.
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