Deep brain stimulation for refractory epilepsy

Deep Brain Stimulation (DBS) is used for selected patients with medically refractory epilepsy for whom surgical resection is considered unsuitable

• involves electrical stimulation of specific sites within the brain (such as the anterior nucleus of the thalamus), which may suppress abnormal electrical activity associated with seizures
• DBS for refractory epilepsy is carried out with the patient under local or general anaesthesia. One or more permanent electrodes are inserted into the brain using imaging guidance
  • following satisfactory electrode testing, a pulse generator is implanted under the chest wall and connected by tunnelled wires to the electrodes. The generator usually remains switched 'on'

NICE have stated that "..The evidence on the efficacy of deep brain stimulation (DBS) for refractory epilepsy is limited in both quantity and quality. The evidence on safety shows that there are serious but well-known side effects. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.."

Reference;

• 1) NICE (January 2012). Deep brain stimulation for refractory epilepsy