Role of Neuromodulation for Treatment of Drug-Resistant Epilepsy

Neurol India. 2020 Nov-Dec;68(Supplement):S249-S258. doi: 10.4103/0028-3886.302476.

Abstract

The choice of neuromodulation techniques has greatly increased over the past two decades. While vagal nerve stimulation (VNS) has become established, newer variations of VNS have been introduced. Following the SANTE's trial, deep brain stimulation (DBS) is now approved for clinical use. In addition, responsive neurostimulation (RNS) has provided exciting new opportunities for treatment of drug-resistant epilepsy. While neuromodulation mostly offers only a 'palliative' measure, it still provides a significant reduction of frequency and intensity of epilepsy. We provide an overview of all the techniques of neuromodulation which are available, along with long-term outcomes. Further research is required to delineate the exact mechanism of action, the indications and the stimulation parameters to extract the maximum clinical benefit from these techniques.

Keywords: Deep brain stimulation; drug-refractory epilepsy; neuromodulation; outcome; responsive neurostimulation; vagal nerve stimulation.

MeSH terms

  • Deep Brain Stimulation*
  • Drug Resistant Epilepsy* / therapy
  • Epilepsy* / therapy
  • Humans
  • Pharmaceutical Preparations*
  • Vagus Nerve Stimulation*

Substances

  • Pharmaceutical Preparations