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首页> 外文期刊>Neurosurgical focus >Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review
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Cerebellar stimulation in the management of medically intractable epilepsy: a systematic and critical review

机译：小脑刺激治疗难治性癫痫：一项系统和关键的审查。

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Object. The wide application of deep brain stimulation in the management of movement as well as other degenerative neurological and psychiatric disorders has renewed the interest in using deep brain stimulation in the management of medically intractable epilepsy. Various stimulation targets have been used with significantly varying results in aborting seizure activity. Electrical cerebellar stimulation (CS) has been used for more than 50 years in the management of epilepsy, with conflicting results. In the current study, the authors review the pertinent literature to outline the role of CS in the management of medically refractory epilepsy.Methods. The PubMed medical database was systematically searched for the following terms: "cerebellar," "epilepsy," "stimulation," and "treatment," and all their combinations. Case reports were excluded from this study.Results. The pertinent articles were categorized into 2 large groups: animal experimental and human clinical studies. Particular emphasis on the following aspects was given when reviewing the human clinical studies: their methodological characteristics, the number of participants, their seizure types, the implantation technique and its associated complications, the exact stimulation target, the stimulation technique, the seizure outcome, and the patients' psychological and social poststimulation status. Three clinical double-blind studies were found, with similar implantation surgical technique, stimulation target, and stimulation parameters, but quite contradictory results. Two of these studies failed to demonstrate any significant seizure reduction, whereas the third one showed a significant poststimulation decrease in seizure frequency. All possible factors responsible for these differences in the findings are analyzed in the present study.Conclusions. Cerebellar stimulation seems to remain a stimulation target worth exploring for defining its potential in the treatment of medically intractable epilepsy, although
机译：目的。深层脑刺激在运动以及其他退行性神经和精神疾病的管理中得到了广泛的应用，这引起了人们对在医疗上难治性癫痫的治疗中使用深脑刺激的兴趣。在中止癫痫发作活动中，已经使用了各种刺激目标，其结果差异很大。小脑电刺激（CS）在癫痫的治疗中已经使用了50多年，其结果相互矛盾。在本研究中，作者回顾了相关文献，概述了CS在治疗难治性癫痫中的作用。在PubMed医学数据库中系统搜索了以下术语：“小脑”，“癫痫病”，“刺激”和“治疗”及其所有组合。病例报告不包括在本研究中。相关文章分为两大类：动物实验和人类临床研究。在审查人类临床研究时，特别强调以下几个方面：方法学特征，参与者人数，癫痫发作类型，植入技术及其相关并发症，确切的刺激目标，刺激技术，癫痫发作的结局，以及患者的心理和社会后刺激状态。发现了三项临床双盲研究，它们具有相似的植入手术技术，刺激目标和刺激参数，但结果相矛盾。这些研究中有两项未能证明癫痫发作明显减少，而第三项研究表明刺激后癫痫发作频率显着降低。在本研究中分析了造成这些发现差异的所有可能因素。尽管定义小脑刺激在医学上难治性癫痫中的潜力，但小脑刺激似乎仍然是值得探索的刺激目标

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