Neurostimulation in treating pharmacoresistant epilepsy

The contemporary care of patients with pharmacologically unmanageable epilepsy increasingly involves the use of neurostimulationmethods. The reason is an entirely legitimate effort to offer a substantially better quality of life even in those in whomresection epilepsy surgery is not suitable for serious reasons. In the case of neurostimulation, palliative interventions are used,i.e. their goal is to at least significantly reduce the number of seizures, particularly those where there is a risk of injury. Althoughcomplete suppression of seizures is relatively rare with their use, standard neurostimulation techniques have been shown to havelong-term efficacy in more than half of the individuals treated. Moreover, their typical feature is that, with increasing durationof stimulation, their efficacy improves progressively. The method of chronic vagus nerve stimulation, whose benefit has beenconfirmed numerous times in both adult and paediatric patients with various types of epilepsy, has been the longest and mostfrequently used method in the practice. More recently, methods of deep brain stimulation (particularly stimulation of the anteriorthalamic nuclei) have been introduced in clinical epileptology. The methods of transcutaneous cranial nerve stimulation (the vagusnerve and the trigeminal nerve) are also currently available for clinical use; however, their true efficacy still remains uncertain.

Keywords: vagus nerve stimulation, deep brain stimulation, transcutaneous cranial nerve stimulation, pharmacoresistant epilepsy