REVIEW
Introdução: A epilepsia é um distúrbio neurológico crônico comum. Na maioria dos pacientes, as medicações antiepilépticas auxiliam no controle das convulsões, mas em aproximadamente 20 a 30% dos casos a doença é refratária ao uso de medicação. Nesses casos existem algumas modalidades terapêuticas, como o estímulo cerebral profundo, que tem como alvo o núcleo anterior do tálamo (NAT). Objetivos: Comparação de artigos sobre estimulação cerebral profunda em relação às complicações e resultados nas epilepsias refratárias a medicações. Métodos: Foram coletados 12 artigos publicados entre 2004 e 2019, nas bases de dados LILACS, PubMed e Scielo, sobre a estimulação cerebral profunda em epilepsia e comparados os seus resultados quanto ao sucesso e complicações da terapia utilizada. Resultados: A partir da metanálise dos dados analisados, foi observado que, em média, para um N=24,8, em um tempo de seguimento de 10,9 a 45,41 meses, com os parâmetros de estimulação de 122-145 Hz, 3,75-5.69 V, e 87,5-100 μs, houve uma redução da frequência mensal média de crises de 55,1%. Conclusão: Estimulação cerebral profunda do núcleo anterior do tálamo (ANT-DBS) para epilepsia refratária a medicamentos é uma terapia segura. Apesar disso, estudos clínicos em busca do alvo ideal, em populações bem definidas, ainda são importantes.
Background: Epilepsy is a common chronic neurological disorder. In most patients, antiepileptic medications help to control seizures, but in approximately 20% to 30% of cases, the disease is refractory to the use of medication. In these cases, there are some therapeutic modalities for refractory epilepsy, such as deep brain stimulation, which can target the anterior nucleus of the thalamus (ANT). Objectives: Comparison of articles on deep brain stimulation in relation to complications and outcomes in drug-resistant epilepsy. Methods: Twelve articles published between 2004 and 2019 in the LILACS, PubMed and Scielo databases were collected on deep brain stimulation in epilepsy and their results were compared regarding the success and complications of the therapy used. Results: From the meta-analysis of the data, it was observed that, on average, for an N = 24.8, in a follow-up time of 10.9 to 45.41 months, with the stimulation parameters of 122-145 Hz, 3.75-5.69 V and 87.5-100 μs, there was an average reduction of 55.1% in the monthly seizure frequency. Conclusions: Deep brain stimulation of the anterior thalamus nucleus (ANT-DBS) for drug-refractory epilepsy is a welltolerated therapy. However, clinical studies in search of the ideal target, in well-defined populations, are still important.
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1 Medical student, ABC Medicine School – FMABC, Santo André (SP), Brazil.
2 Medical student, School of Medicine of Pontifical Catholic University of São Paulo – PUC-SP, Sorocaba (SP), Brazil.
3 MD, PhD, Department of Neurology, Pontifical Catholic University of São Paulo – PUC-SP, Sorocaba (SP), Brazil.
4 MD, PhD, Department of Neurosurgery, Santa Paula Hospital, São Paulo (SP), Brazil.
Received Apr 12, 2022
Corrected: Aug 3, 2022
Accepted: Aug 3, 2022
