审慎开展丘脑前核电刺激治疗顽固性癫痫:现状与思考  

Prudently applying the therapy of anterior thalamic stimulation for refractory epilepsy: present situation and thinking

作　　者：周洪语[1] Zhou Hongyu(Department of Functional Neurology,Renji Hospital,Shanghai Jiaotong University School of Medicine, Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院功能神经科,200127

出　　处：《中华神经科杂志》2019年第2期147-150,共4页Chinese Journal of Neurology

摘　　要：近期,美国食品药品监督管理局批准了丘脑前核脑深部电刺激(DBS)疗法作为部分性发作的成人难治性癫痫的辅助治疗。基于丘脑前核为Papez边缘环路的重要节点,有学者推测,对于致痫病灶位于边缘环路或者癫痫放电在边缘环路中传播,丘脑前核可能是治疗靶点。有文献总结与疗效相关影响因素,但因临床数据有限,尚不能给出确定性预测指标和预后判断。癫痫的DBS治疗,其核心理念依然是临床医生对每例患者详尽的"解剖-电-临床"分析和个体化选择。Recently, the U.S. Food and Drug Administration has granted premarket approval for bilateral anterior thalamic nucleus stimulation as adjunctive treatment for reducing the frequency of partial-onset seizures in adults who are refractory to three or more antiepileptic medications. The anterior nucleus of the thalamus (ANT) is a primary component of the limbic system (the Papez circuit), which represents a fundamental pathway for seizure propagation. Scholars speculated that ANT is an anatomic target that may halt or influence seizure propagation or epileptogenic foci originating within the limbic system. Some suggestions on the possible factors associated with the efficacy of ANT stimulation put forward by experts are helpful. However, given the limited clinical data, there is a lack of valid predictors of individual treatment response. Most importantly, rational patient selection relies on a detailed and careful anatomo-electro-clinical analysis for individualized treatment.

关 键 词：癫痫 深部脑刺激法 前丘脑核 

分 类 号：R742.1[医药卫生—神经病学与精神病学]