Abstract:
There are limited treatment options for drug-resistant epilepsy (DRE) in children. We performed a pilot study to investigate the tolerability and effectiveness of cathodal transcranial direct current stimulation (tDCS) in DRE. Twelve children with DRE of varied etiology underwent three to four daily sessions of cathodal tDCS. The seizure frequency at 2 weeks before and after tDCS was obtained from seizure diaries; clinic reviews at 3 and 6 months assessed any longer-term benefits or adverse effects. The spike wave index (SWI) was analyzed in the EEGs done immediately before and after tDCS on the first and last day of tDCS. One child remained seizure free for a year after tDCS. One child had reduced frequency of ICU admissions for status epilepticus for 2 weeks, likely due to reduced severity of seizures. In four children, an improvement in alertness and mood was reported for 2-4 weeks after tDCS. There was no benefit following tDCS in the other children. There were no unexpected or serious adverse effects in any child. Benefit was seen in two children, and the reasons for the lack of benefit in the other children need further study. It is likely that tDCS stimulus parameters will need to be tailored for different epilepsy syndromes and etiologies.
摘要:
儿童耐药性癫痫(DRE)的治疗选择有限。我们进行了一项初步研究,以研究DRE中阴极经颅直流电刺激(tDCS)的耐受性和有效性。十二名病因各异的DRE儿童每天接受三到四次阴极tDCS治疗。从癫痫发作日记中获得tDCS前后2周的癫痫发作频率;3个月和6个月的临床审查评估了任何长期益处或不良反应。在tDCS的第一天和最后一天,在tDCS之前和之后立即进行的EEG中分析了尖峰波指数(SWI)。一名儿童在tDCS后一年内没有癫痫发作。一名儿童因癫痫持续状态入院ICU的频率减少了2周,可能是由于癫痫发作的严重程度降低。在四个孩子中,据报道,在tDCS后2-4周内,警觉性和情绪均有所改善.其他孩子在tDCS之后没有任何好处。任何儿童都没有意外或严重的不良反应。在两个孩子身上看到了好处,以及其他孩子缺乏益处的原因需要进一步研究。tDCS刺激参数可能需要针对不同的癫痫综合征和病因进行定制。